Genetic testing for hereditary cancer: Unproven codes for RNA testing

Last modified: July 2, 2021

Effective Dec. 1, 2020, 11 codes for RNA testing have been removed from the prior authorization requirement. These codes will deny, no matter the prior authorization status, as the Genetic Testing for Hereditary Cancer medical policy states, “genetic testing for BRCA1 and BRCA2 or Multi-Gene hereditary panels with RNA testing is unproven.” The medical policy for commercial and Medicaid members has also been updated to include these codes.

This change does not affect other BRCA1 testing, BRCA2 testing or multi-gene hereditary cancer panels, which will continue to require prior authorization.