Biomarkers Overview
JH · Effective Oct 1, 2015
24 active Medicare policies list 81426, and 13 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 Jul 17, 2023
JH · Effective Jul 17, 2023
JL · Effective Jul 17, 2023
J15 · Effective Oct 1, 2015
JE · Effective Oct 1, 2015
JF · Effective Oct 1, 2015
JJ · Effective Oct 1, 2015
13 policies from 8 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of 81426 |
|---|---|---|
| Concert Genetic Testing Oncology: Solid Tumor Molecular Diagnostics | Not recorded | Referenced |
| Concert Genetic Testing: Multisystem Genetic Conditions | Not recorded | Referenced |
| Concert Genetic Testing: Prenatal Diagnosis | Not recorded | Referenced |
| Policy | Effective | Status of 81426 |
|---|---|---|
| Genetic Testing |
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
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
| Feb 27, 2024 |
| Covered |
| Tuberculosis Testing | Feb 16, 2024 | Covered |
|---|
| Policy | Effective | Status of 81426 |
|---|---|---|
| Genetic Testing for Hereditary Cancer | Oct 1, 2026 | Covered |
| Whole Exome and Whole Genome Sequencing (Non-Oncology Conditions) | Oct 1, 2026 | Covered |
| Policy | Effective | Status of 81426 |
|---|---|---|
| Genetic Testing for Hereditary Cancer | Oct 1, 2026 | Covered |
| Whole Exome and Whole Genome Sequencing (Non-Oncology Conditions) | Oct 1, 2026 | Covered |
| Policy | Effective | Status of 81426 |
|---|---|---|
| Whole Exome Sequencing and Whole Genome Sequencing | Not recorded | Covered |
| Policy | Effective | Status of 81426 |
|---|---|---|
| Cigna Comprehensive Code List - Effective 03/07/2026 | Mar 7, 2026 | Prior auth required |
| Policy | Effective | Status of 81426 |
|---|---|---|
| Rapid Whole Genome Sequencing (rWGS) of Critically Ill Infants | Feb 16, 2024 | Covered with conditions |
| Policy | Effective | Status of 81426 |
|---|---|---|
| Genetic Testing for Hereditary Cancer | Oct 1, 2026 | Covered |