Medicare AdvantageAdministrativeLow impact
MA06.014e, Pharmacogenetics and Metabolite Monitoring for Using Azathioprine (AZA)/6-Mercaptopurine (6-MP) Therapy
Independence Blue Cross·NJ · Rheumatology, Gastroenterology, Oncology +3 more·Medical Policy
We identified it
Sep 17, 2026
Summary
This is a reissue with no substantive changes to Independence Blue Cross Medicare Advantage policy MA06.014e covering pharmacogenetic testing (TPMT genotyping/phenotyping) and metabolite monitoring for azathioprine/6-mercaptopurine therapy. The policy remains in effect as originally issued on 01/01/2024 for New Jersey MA plans, with procedure code 84433 continuing to be recognized for metabolite monitoring.
Action Required
No immediate action required. This is a routine annual reissue with no changes to coverage criteria, billing codes, or medical necessity requirements. Billing team should note that the policy remains current and enforceable through at least 09/16/2026. Verify that claims for TPMT genotyping (CPT 81401), phenotyping (CPT 82542 or 82657), and metabolite monitoring (CPT 84433) continue to include required documentation of medical necessity per the policy guidelines for Independence Blue Cross Medicare Advantage members in New Jersey.