CommercialAdministrativeLow impact
06.02.29g, AlloMap™ Molecular Expression Testing for Heart Transplant Rejection (Independence Administrators)
Independence Blue Cross·Cardiology, Cardiothoracic Surgery, Transplant Surgery +1 more·Pharmacy
Effective date
Mar 4, 2026
We identified it
Jun 19, 2026
Summary
This is a reissue with no substantive policy changes to the AlloMap™ Molecular Expression Testing coverage for heart transplant rejection. The only modification is clarification of the disclaimer language to specify that this policy applies only to Independence Administrators claims administrators whose groups have NOT enrolled in the UM vendor program; those enrolled in the UM vendor program should refer to the eviCore Lab Management Program instead. Coverage criteria, billing codes, and medical necessity requirements remain unchanged.
Action Required
By March 4, 2026: Billing team must verify member eligibility and confirm whether their group has enrolled in the UM vendor program before submitting AlloMap™ claims (CPT 81595, G0452). If the group is enrolled in the UM vendor program, direct providers and coders to reference the eviCore Lab Management Program policy instead. Update internal billing notes and eligibility verification systems to include this UM vendor program status check. Claims submitted without proper verification of program enrollment may be denied or require rework.