CommercialAdministrativeMedium impact
06.02.10r, Genetic Testing for Inherited Susceptibility to Colon Cancer and Microsatellite Instability Testing (Familial Adenomatous Polyposis and Lynch Syndrome) (Independence Administrators)
Independence Blue Cross·Gastroenterology, Oncology, Pathology +3 more·Medical Policy
We identified it
Sep 17, 2026
Summary
This is a reissue with no substantive changes to Independence Administrators' genetic testing policy for inherited colon cancer susceptibility (FAP and Lynch syndrome). However, the disclaimer language was updated to clarify that this policy only applies to members whose groups have NOT enrolled in the UM vendor program; those enrolled in the eviCore Lab Management Program should refer to that policy instead. Billing teams must verify member enrollment status before processing genetic testing claims.
Action Required
Immediately: Billing team must update member eligibility verification procedures to confirm whether each Independence Administrators group has enrolled in the UM vendor program before processing genetic testing claims. For groups enrolled in the eviCore Lab Management Program, redirect claims and coverage questions to that program's policy rather than this policy (06.02.10r). Update internal reference materials and billing system notes to reflect this distinction. Individual member benefits must be verified before/prior to providing services to ensure the correct policy is applied. Failure to verify enrollment status may result in claim denials or misdirected authorization requests.