CommercialPrior AuthHigh impact
Genetic Testing Update
Blue Cross Blue Shield of Nebraska·NE · Oncology, Gastroenterology, Neurology +4 more·Medical Policy
Effective date
Jul 1, 2024
We identified it
Jun 19, 2026
Summary
Blue Cross Blue Shield of Nebraska updated multiple genetic testing policies effective July 1, 2024, requiring preauthorization for various genetic testing panels including hereditary cancer susceptibility, circulating tumor DNA testing, and tests for neurological, gastroenterology, eye, and connective tissue disorders. All genetic testing now requires prior authorization with specific medical necessity criteria.
Action Required
By July 1, 2024: Billing team must update prior authorization requirements for all genetic testing codes listed. Obtain preauthorization before ordering any genetic testing panels including hereditary cancer susceptibility, circulating tumor DNA, neurological disorder panels, liver fibrosis tests, celiac disease testing, IBD panels, retinal dystrophy panels, and Marfan syndrome testing. Update billing software to flag these codes for prior auth. Claims will be denied without proper authorization.