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Medical Policy Revision: Genetic Testing for Helicobacter Pylori Treatment

Effective September 5, 2016, Horizon Blue Cross Blue Shield of New Jersey will change the way we consider certain claims for genetic testing for Heliobacter pylori (H. phylori) treatment.

According to the guidelines of our medical policy, Genetic Testing for Helicobacter Pylori Treatment, genotyping to determine cytochrome p450 (CYP2C19) genetic polymorphisms is considered investigational for the purpose of managing the treatment of H. pylori infection.

We encourage you to review this policy in our online Medical Policy Manual.

Based on the guidelines of our Genetic Testing for Helicobacter Pylori Treatment medical policy:

  • CPT® code 81225 included on claims for services provided on and after September 5, 2016 will be denied as an investigational service regardless of the submitted diagnosis code(s).

Unless Horizon BCBSNJ gives written notice that all or part of the above changes have been cancelled or postponed, the changes will be applied to claims for dates of service on and after September 5, 2016.

CPT® is a registered trademark of the American Medical Association.

Published on: June 7, 2016, 09:29 a.m. ET
Last updated on: November 25, 2020, 00:23 a.m. ET