CommercialPrior AuthHigh impact
MPC March 2022
Blue Cross Blue Shield of Nebraska·NE · Oncology, Neurology, Dermatology +5 more·Medical Policy
Effective date
Jul 1, 2022
We identified it
Jun 19, 2026
Summary
Blue Cross Blue Shield of Nebraska updated multiple genetic testing medical policies, all requiring preauthorization effective July 1, 2022. The updates include specific coverage criteria for genetic testing panels covering connective tissue disorders, hereditary cancers, oncology molecular analysis, neurological disorders, dermatological conditions, and skeletal dysplasia.
Action Required
By July 1, 2022: Billing team must update system to require prior authorization for all genetic testing codes listed in the policy including hereditary cancer panels, tumor profiling, epilepsy panels, and connective tissue disorder testing. Update encounter forms and EMR templates to prompt providers for required clinical criteria documentation. All genetic testing claims will be denied without proper preauthorization and meeting specific medical necessity criteria outlined in each policy section.