CommercialCoverageMedium 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, Genetics, Oncology·Medical Policy
Effective date
Oct 1, 2025
We identified it
Jun 19, 2026
Summary
Independence Administrators reissued their genetic testing policy (06.02.10r) for inherited susceptibility to colon cancer, FAP, and Lynch syndrome effective October 1, 2025. This is a policy reissue with a recent effective date; billing teams must verify coverage criteria, prior authorization requirements, and applicable billing codes against the full policy text to ensure compliant claim submission.
Action Required
By October 15, 2025: Billing team must obtain and review the complete policy text at https://medpolicy.ibx.com/ibc/Commercial/Pages/Site-Activity-View.aspx?FilterField1=MPSiteActivityLogMonth&FilterValue1=10&FilterField2=MPSiteActivityLogYear&FilterValue2=2025#commercial-06-02-10r to identify specific CPT/HCPCS codes, prior authorization requirements, and medical necessity documentation requirements for genetic testing claims. Update billing system rules, encounter forms, and provider guidelines accordingly. Providers must document applicable indications (family history of FAP, Lynch syndrome, or colorectal cancer) on all genetic testing requisitions. Claims submitted without compliance to updated coverage criteria may be denied.