Medicare AdvantageCoverageMedium impact
Genetic and Coagulation Testing for Noncancer Blood Disorders - Medicare Advantage (Revised)
Humana·Hematology, Genetics, Family Medicine +2 more·Medicare Advantage
Effective date
Feb 2, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage has revised its policy for genetic and coagulation testing for noncancer blood disorders, updating coverage determinations and limitations for conditions like hemophilia, thalassemia, and clotting disorders. The policy consolidates requirements for genetic testing related to blood coagulation issues and references multiple MolDX Local Coverage Determinations across different Medicare Administrative Contractor jurisdictions.
Action Required
Before February 2, 2026: Review and update prior authorization processes for genetic and coagulation testing orders for noncancer blood disorders. Billing team must verify coverage requirements against applicable MolDX Local Coverage Determinations based on practice location and ensure documentation supports medical necessity for tests related to hemophilia, thalassemia, G6PD deficiency, and other inherited blood disorders. Update encounter forms to remind providers of revised coverage limitations.