Biomarkers Overview
JH · Effective Oct 1, 2015
41 active Medicare policies list 81405, and 40 commercial payer policies list it. See each policy's status for the code and its official source. Listing a code is not a coverage decision: read each policy’s source for the requirements that apply.
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JH · Effective Oct 1, 2015
JL · Effective Oct 1, 2015
J9 · Effective Jan 30, 2022
JH · Effective Jan 30, 2022
JL · Effective Jan 30, 2022
J9 · Effective Jul 17, 2023
JH · Effective Jul 17, 2023
JL · Effective Jul 17, 2023
J15 · Effective Aug 21, 2022
40 policies from 6 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
Showing 10 of 16 · All Ambetter policies
| Policy | Effective | Status of 81405 |
|---|---|---|
| Concert Genetic Testing Oncology: Hematologic Malignancy | Not recorded | Referenced |
| Concert Genetic Testing: Cardiovascular | Not recorded | Referenced |
| Concert Genetic Testing: Endocrinology | Not recorded | Referenced |
| Concert Genetic Testing: Gastroenterology | Not recorded | Referenced |
| Concert Genetic Testing: Hematology |
JE · Effective Aug 8, 2022
JF · Effective Aug 8, 2022
JJ · Effective Jul 3, 2022
JM · Effective Jul 3, 2022
J5 · Effective Jul 3, 2022
J8 · Effective Jul 3, 2022
J15 · Effective Oct 1, 2015
JE · Effective Oct 1, 2015
JF · Effective Oct 1, 2015
JJ · Effective Oct 1, 2015
JM · Effective Oct 1, 2015
J5 · Effective Feb 16, 2017
J8 · Effective Feb 16, 2017
J9 · Effective Oct 1, 2015
J6 · Effective Oct 1, 2015
JK · Effective Oct 1, 2015
JL · Effective Jan 1, 2025
J9 · Effective Jan 1, 2025
National · Effective Jan 1, 2026
National · Effective Feb 5, 2026
National · Effective Oct 1, 2025
J5 · Effective Jan 1, 2026
National · Effective Jan 1, 2026
National · Effective Jan 1, 2026
National · Effective Feb 5, 2026
J5 · Effective Apr 1, 2026
JL · Effective Apr 1, 2026
J9 · Effective Apr 1, 2026
J6 · Effective Feb 12, 2026
J9 · Effective Jan 1, 2024
| Not recorded |
| Referenced |
| Concert Genetic Testing: Hereditary Cancer | Not recorded | Referenced |
|---|
| Concert Genetic Testing: Immunology and Rheumatology | Not recorded | Referenced |
|---|
| Concert Genetic Testing: Multisystem Genetic Conditions | Not recorded | Referenced |
|---|
| Concert Genetic Testing: Nephrology | Not recorded | Referenced |
|---|
| Concert Genetic Testing: Neurology | Not recorded | Referenced |
|---|
Showing 10 of 12 · All Regence BCBS policies
| Policy | Effective | Status of 81405 |
|---|---|---|
| Expanded Molecular Testing of Cancers to Select Targeted Therapies | Jul 1, 2026 | Covered |
| Genetic Testing for Alzheimer's Disease | Jun 1, 2026 | Covered |
| Genetic Testing for Epilepsy | Jan 1, 2026 | Covered |
| Genetic Testing for Familial Hypercholesterolemia | Mar 1, 2026 | Covered |
| Genetic Testing for Heritable Disorders of Connective Tissue | Sep 1, 2025 | Covered |
| Genetic Testing for Macular Degeneration | Oct 1, 2025 | Covered |
| Genetic Testing for Primary Mitochondrial Disorders | Mar 1, 2026 | Covered |
| Genetic Testing for Rett Syndrome | Nov 1, 2025 | Covered |
| Genetic Testing for the Diagnosis of Inherited Peripheral Neurophathies | May 1, 2026 | Covered |
| Invasive Prenatal Fetal Diagnostic Testing Using Chromosomal Abnormalities | Aug 1, 2026 | Covered |
| Policy | Effective | Status of 81405 |
|---|---|---|
| Carrier Screening in the Reproductive Setting | Not recorded | Covered |
| Carrier Screening in the Reproductive Setting | Not recorded | Covered |
| Chromosomal Microarray Analysis | Not recorded | Covered |
| Hereditary Cancer Testing | Not recorded | Covered |
| Predictive and Prognostic Polygenic Testing | Not recorded | Covered |
| Policy | Effective | Status of 81405 |
|---|---|---|
| Alzheimer's Disease Tests | Sep 8, 2023 | Covered |
| Genetic Testing | Feb 27, 2024 | Covered |
| Huntington's Disease | Sep 12, 2023 | Covered |
| Liver Transplantation | Aug 9, 2023 | Covered |
| Policy | Effective | Status of 81405 |
|---|---|---|
| Cigna Comprehensive Code List - Effective 03/07/2026 | Mar 7, 2026 | Prior auth required |
| Pharmacogenetic Testing | Jul 15, 2026 | Covered |
| Policy | Effective | Status of 81405 |
|---|---|---|
| Tier 2 Molecular Pathology Procedures | Not recorded | Covered |