Medical Policy Update: Genetic Testing for Lactase Insufficiency
Effective April 13, 2018, the guidelines of our medical policy, Genetic Testing for Lactase Insufficiency, will also be applied to certain genetic testing claims rendered for patients enrolled in Horizon Blue Cross Blue Shield of New Jersey Medicare Advantage (MA) plans. Presently the guidelines of this medical policy have not been applied to claims for services provided to MA members.
We encourage you to review this policy content in our Medical Policy Manual.
Based on the guidelines of our medical policy, Genetic Testing for Lactase Insufficiency, and the submitted diagnosis code(s), claims for services provided on and after April 13, 2018 to members enrolled in Horizon BCBSNJ MA plans will be processed as noted below.
- Claims that include CPT® code 81400 may pend while information required to determine medical appropriateness is requested and reviewed.
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 on and after April 13, 2018.
CPT® is a registered mark of the American Medical Association.