CommercialAdministrativeLow impact
06.02.31g, Genetic Testing for Congenital Long QT Syndrome (Independence Administrators)
Independence Blue Cross·Cardiology, Genetics, Pathology·Medical Policy
We identified it
Jun 19, 2026
Summary
This is a reissue of policy 06.02.31g with no substantive changes to coverage criteria for genetic testing of congenital Long QT Syndrome. The only modification is clarification of the applicability disclaimer: the policy now explicitly excludes groups enrolled in the UM vendor program, replacing the previous reference to eviCore Lab Management Program. Billing teams should verify member eligibility and UM vendor enrollment status before processing genetic testing claims.
Action Required
No immediate action required. This is a routine annual reissue with no changes to medical necessity criteria, covered procedures, or billing codes. Billing teams should update internal policy files to reflect the current disclaimer language (noting that the policy does not apply to groups enrolled in Independence's UM vendor program). Continue to verify individual member benefits and confirm that Independence Administrators serves as the claims administrator before processing genetic testing claims for Long QT Syndrome (CPT 0237U, 81413). For members in groups enrolled in the UM vendor program, refer to the eviCore Lab Management Program guidance.