RET Proto-Oncogene Testing (CPB 0319, reviewed 2026-06-08)
Effective date
Not stated in the notice
Identified
Aug 16, 2026
Summary
Aetna considers germline RET proto-oncogene testing medically necessary for members with a personal history of medullary thyroid carcinoma (familial or apparently sporadic), pheochromocytoma or paraganglioma when multiple endocrine neoplasia type 2 (MEN2) is suspected, parathyroid adenoma or hyperplasia when MEN2A is suspected, C-cell hyperplasia on pathology, or clinical features of MEN2B. Family history criteria include a first-degree blood relative with medullary thyroid carcinoma, a first-degree or second-degree blood relative with a known germline RET pathogenic variant, and a family pattern consistent with familial medullary thyroid carcinoma. Germline RET testing for all other indications, such as non-small cell lung cancer, is considered experimental, investigational, or unproven.
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01Billing team: Bill CPT 81404, 81405, 81406 or 88271, or HCPCS S3840, for RET testing only when the member meets one of the policy's criteria.
02Isolated Hirschsprung disease is not an indication for RET genetic testing.
03Hirschsprung disease qualifies only when a first-degree blood relative has MEN2, or when the family history includes medullary thyroid carcinoma, pheochromocytoma or paraganglioma, or parathyroid adenoma or hyperplasia.
04ICD-10 codes C34.00 through C34.92 (non-small cell lung cancer) are not covered for RET testing under this policy.
05RET fusion testing for members with non-small cell lung cancer is addressed in CPB 0715.
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