CommercialPrior AuthHigh impact
Genetic Testing Update
Blue Cross Blue Shield of Nebraska·NE · Oncology, Hematology, OB-GYN +6 more·Medical Policy
Effective date
Jan 1, 2025
We identified it
Jun 19, 2026
Summary
Blue Cross Blue Shield of Nebraska is updating genetic testing policies effective January 1, 2025, requiring preauthorization for hereditary cancer susceptibility panels, tumor analysis, and circulating tumor DNA testing. Multiple new coverage criteria and billing codes are being added for specific genetic tests including BRCA panels, neuroendocrine cancer panels, and liquid biopsy testing.
Action Required
Before January 1, 2025: Billing team must update system to require preauthorization for all genetic testing codes listed in the policy (hereditary cancer panels, tumor analysis, HLA typing, and circulating tumor DNA tests). Update encounter forms and EMR templates to remind providers of new prior auth requirements. Train staff on new medical necessity criteria for each test type. Failure to obtain preauthorization will result in claim denials.