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Genetic and Coagulation Testing for Noncancer Blood Disorders - Medicare Advantage (Revised)
Effective date
Oct 12, 2026
Identified
Oct 10, 2026
Summary
Humana Medicare Advantage revised its policy on genetic and coagulation testing for noncancer blood disorders, effective 10/12/2026. The policy covers testing for conditions including hemophilia, thrombophilia, hemoglobinopathies, G6PD deficiency, and Fanconi anemia, with coverage determinations tied to applicable Medicare Administrative Contractor (MAC) Local Coverage Determinations (LCDs) by geographic jurisdiction.
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What to do
Action · 4 steps
01Effective 10/12/2026, the billing team should verify current applicability of this revised policy for Medicare Advantage members and confirm that genetic and coagulation testing claims comply with the applicable MAC LCD for the member's geographic jurisdiction.
02Review the related MAC-specific LCDs referenced in the policy (organized by MAC J-codes covering specific states) to ensure correct billing and prior authorization requirements.
03Refer to the CMS Medicare Coverage Database for the most current applicable NCD/LCD/LCA to avoid claim denials.
04No specific CPT or HCPCS codes are listed in this policy document; claims should be coded according to the applicable MAC LCD in the member's service area.
Original notice
Genetic and Coagulation Testing for Noncancer Blood Disorders - Medicare Advantage (Revised)
mcp.humana.com · Always check the source before changing claims.
Related changes
See all Humana changes →Genetic Testing for Hematologic Malignancies and Suspected Myeloid Disorders - Medicare Advantage (Revised)MediumEffective Oct 12, 2026 · Medicare AdvantageGenetic and Coagulation Testing for Noncancer Blood Disorders - Medicare Advantage (Revised)HighEffective Feb 2, 2026 · Medicare AdvantageGenetic and Coagulation Testing for Noncancer Blood Disorders - Medicare Advantage (Revised)MediumEffective Feb 2, 2026 · Medicare AdvantageBrowse every Humana change in the policy list