P F
Aug 1, 2019

Gene Expression Profiling and Protein Biomarkers for Prostate Cancer Management

Effective October 1, 2019, the Prolaris™ assay (CPT code 81541) found in the medical policy Gene Expression Profiling and Protein Biomarkers for Prostate Cancer Management will no longer require prior authorization for BlueCHiP for Medicare, as it will be changed to a not covered service. There will be no change to commercial products; the service will remain not medically necessary. Additionally, the OncotypeDX AR-V7 Nuclear Detect assay, filed with Unlisted CPT code 81479, will require prior authorization through the online authorization tool for BlueCHiP for Medicare and will be considered not medically necessary for commercial products. You can view the full text of this policy here.