Biomarkers Overview
JH · Effective Oct 1, 2015
88 active Medicare policies list 81599, and 25 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
J5
J8
25 policies from 10 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of 81599 |
|---|---|---|
| Algorithmic Tests for Liver Fibrosis | Oct 1, 2026 | Not covered |
| Blood-based Biomarker Tests for Multiple Sclerosis | Oct 1, 2026 | Not covered |
| Fecal Analysis Panels in the Diagnosis of Intestinal Disorders | Jul 1, 2026 | Not covered |
| Immune Cell Function Assay | Jan 6, 2026 | Not covered |
| Molecular Signature Test for Predicting Response to Tumor Necrosis Factor Inhibitor Therapy | Oct 1, 2026 | Not covered |
| Nucleic Acid Amplification Tests Using Algorithmic Analysis for the Diagnosis of Vaginitis |
J15 · Effective Aug 10, 2026
JE · Effective Aug 10, 2026
JF · Effective Aug 10, 2026
JJ · Effective Aug 10, 2026
JM · Effective Aug 10, 2026
J5 · Effective Aug 10, 2026
J8 · Effective Aug 10, 2026
J15 · Effective Jun 24, 2019
JE · Effective Feb 10, 2019
JF · Effective Feb 10, 2019
JJ · Effective Dec 3, 2018
JM · Effective Dec 3, 2018
J5 · Effective Aug 12, 2019
J8 · Effective Aug 12, 2019
J15 · Effective Oct 15, 2023
JE · Effective Oct 15, 2023
JF · Effective Oct 15, 2023
JJ · Effective Oct 15, 2023
JM · Effective Oct 15, 2023
J5 · Effective Oct 15, 2023
J8 · Effective Oct 15, 2023
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
J5 · Effective Jun 6, 2021
J8 · Effective Jun 6, 2021
J15 · Effective Jun 6, 2021
J15 · Effective Aug 30, 2026
JE · Effective Aug 30, 2026
JF · Effective Aug 30, 2026
JJ · Effective Aug 30, 2026
JM · Effective Aug 30, 2026
J5 · Effective Aug 30, 2026
J8 · Effective Aug 30, 2026
J9 · Effective Oct 1, 2015
J6 · Effective Oct 1, 2015
JK · Effective Oct 1, 2015
J6 · Effective Dec 1, 2021
JK · Effective Dec 1, 2021
National · Effective Oct 1, 2026
National · Effective Oct 1, 2026
National · Effective Oct 1, 2026
National · Effective Oct 1, 2026
J5 · Effective Oct 1, 2025
National · Effective Oct 1, 2025
National · Effective Oct 1, 2025
National · Effective Jan 22, 2026
National · Effective Jan 1, 2025
National · Effective Jan 22, 2026
National · Effective Aug 7, 2025
J5 · Effective Jan 1, 2025
National · Effective Jul 1, 2026
National · Effective Jul 1, 2026
National · Effective Jul 1, 2026
J5 · Effective Jul 1, 2026
National · Effective Aug 30, 2026
National · Effective Aug 30, 2026
National · Effective Aug 30, 2026
National · Effective Aug 30, 2026
National · Effective Aug 30, 2026
National · Effective Jul 1, 2026
National · Effective Jul 1, 2026
National · Effective Jul 1, 2026
J5 · Effective Jul 1, 2026
JL · Effective Jul 1, 2026
J9 · Effective Jul 1, 2026
J6 · Effective Jul 15, 2026
J6 · Effective Apr 1, 2026
| Oct 1, 2026 |
| Covered |
| Selected Protein Biomarker Algorithmic Assays | Oct 1, 2026 | Not covered |
|---|
| Serum Biomarker Tests for Risk of Preeclampsia | Oct 1, 2026 | Not covered |
|---|
| Policy | Effective | Status of 81599 |
|---|---|---|
| Gene Expression-Based Assays for Cancers of Unknown Primary | Jun 1, 2026 | Covered |
| Genetic Testing for Macular Degeneration | Oct 1, 2025 | Covered |
| Investigational Gene Expression, Biomarker, and Multianalyte Testing | Sep 1, 2026 | Covered |
| Microarray-Based Gene Expression Profile Testing for Multiple Myeloma Risk Stratification | May 1, 2026 | Covered |
| Multianalyte and Gene Expression Assays for Predicting Recurrence in Colon Cancer | Dec 1, 2025 | Covered |
| Policy | Effective | Status of 81599 |
|---|---|---|
| Concert Genetic Testing Oncology: Algorithmic Assays | Not recorded | Referenced |
| Concert Genetic Testing Oncology: Cancer Screening and Surveillance | Not recorded | Referenced |
| Concert Genetic Testing: Ophthalmology | Not recorded | Referenced |
| Policy | Effective | Status of 81599 |
|---|---|---|
| Predictive and Prognostic Polygenic Testing | Jun 14, 2026 | Covered |
| Prenatal Screening using Cell-free DNA | Sep 19, 2026 | Covered |
| Prenatal Screening using Cell-free DNA [for Wellpoint Massachusetts] | Sep 20, 2025 | Covered |
| Policy | Effective | Status of 81599 |
|---|---|---|
| Cigna Comprehensive Code List | Mar 7, 2026 | Prior auth required |
| Policy | Effective | Status of 81599 |
|---|---|---|
| Rheumatoid Arthritis: Biologic Markers and Pharmacologic Assessment | Oct 1, 2025 | Covered |
| Policy | Effective | Status of 81599 |
|---|---|---|
| Molecular Oncology Testing for Hematologic Cancer Diagnosis, Prognosis, and Treatment Decisions | Aug 1, 2026 | Covered |
| Policy | Effective | Status of 81599 |
|---|---|---|
| Molecular Oncology Testing for Hematologic Cancer Diagnosis, Prognosis, and Treatment Decisions | Aug 1, 2026 | Covered |
| Policy | Effective | Status of 81599 |
|---|---|---|
| Molecular Oncology Testing for Hematologic Cancer Diagnosis, Prognosis, and Treatment Decisions | Aug 1, 2026 | Covered |
| Policy | Effective | Status of 81599 |
|---|---|---|
| Molecular Pathology/Genetic Testing Reported with Unlisted Codes | Not recorded | Covered |