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CommercialCoverageLow impact

06.02.43b, Proteomic (Protein)-Based Testing for the Evaluation of Ovarian (Adnexal) Masses Using OVA1® Test and Risk of Ovarian Malignancy Algorithm (ROMA™)

Independence Blue Cross·PA · OB-GYN, Oncology, Pathology·Pharmacy
Effective date
Not stated
We identified it
Jun 19, 2026
Days to comply
—

Summary

Independence Blue Cross reissued policy 06.02.43b on 09/03/2025 with no substantive changes. The policy continues to classify proteomic-based ovarian cancer testing (OVA1®, Overa™, and ROMA™) as experimental/investigational and not covered for commercial members. No billing, coverage, or documentation changes have been made.

Action Required

Action needed
No immediate action required. This is a routine annual policy reissue with no changes to coverage, billing codes, or requirements. Billing team should confirm that claims for CPT codes 0003U, 81500, and 81503 continue to be denied as experimental/investigational for commercial members per existing procedures. Maintain current denial protocols without modification.

Affected Billing Codes

81500
81503

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