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Genetic Testing Update
Blue Cross Blue Shield of Nebraska·NE · Oncology, Gastroenterology, OB-GYN +3 more·Medical Policy
Effective date
Jan 1, 2026
We identified it
Jun 19, 2026
Summary
Blue Cross Blue Shield of Nebraska is implementing new preauthorization requirements and updated medical necessity criteria for genetic testing effective January 1, 2026. This includes specific criteria for CDH1 testing for hereditary gastric cancer, BAP1 testing for tumor predisposition syndrome, hereditary polyposis panels, breast/ovarian cancer panels, and molecular profiling via circulating tumor DNA.
Action Required
By January 1, 2026: Billing team must update systems to require preauthorization for all genetic testing covered under this policy including CDH1, BAP1, hereditary polyposis panels, breast/ovarian cancer panels, and molecular profiling via circulating tumor DNA. Providers must verify patients meet specific medical necessity criteria before ordering tests. Update encounter forms and EMR templates to include new criteria checklists. Claims without proper preauthorization will be denied.