BRCA1 and BRCA2 Genetic Testing
J9 · Effective Apr 11, 2016
27 active Medicare policies list D05.00, and 14 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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J9 · Effective Apr 11, 2016
JJ · Effective Feb 19, 2023
JM · Effective Feb 19, 2023
J15 · Effective Aug 21, 2022
JE · Effective Aug 8, 2022
JF · Effective Aug 8, 2022
JJ · Effective Jul 3, 2022
JM · Effective Jul 3, 2022
14 policies from 2 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of D05.00 |
|---|---|---|
| Analysis of Volatile Organic Compounds | Oct 3, 2023 | Covered |
| Breast Biopsy Procedures | Apr 26, 2023 | Covered |
| Breast Reconstructive Surgery | Apr 7, 2023 | Covered |
| Breast Transillumination, Electrical Impedance Scanning (EIS), and Elastography | Dec 5, 2023 | Covered |
| BreastCare/BreastAlert Differential Temperature Sensor | May 30, 2023 | Covered |
| Cryoablation | Dec 5, 2023 | Covered |
J5 · Effective Jul 3, 2022
J8 · Effective Jul 3, 2022
J6 · Effective Oct 1, 2015
JK · Effective Oct 1, 2015
J9 · Effective Oct 1, 2015
JJ · Effective Jun 12, 2017
JM · Effective Jun 12, 2017
J9 · Effective Oct 1, 2025
National · Effective Oct 1, 2025
National · Effective Aug 6, 2026
National · Effective Aug 13, 2026
National · Effective Aug 6, 2026
J5 · Effective Aug 6, 2026
J6 · Effective Jul 15, 2026
National · Effective Oct 30, 2025
National · Effective Jul 1, 2026
National · Effective Oct 1, 2025
| Gonadotropin-Releasing Hormone Analogs and Antagonists | Jul 14, 2023 | Covered |
|---|
| Intraoperative Radiation Therapy (IORT) | Sep 22, 2023 | Covered |
|---|
| Microwave Thermotherapy | Sep 19, 2023 | Covered |
|---|
| Tumor Markers | Mar 5, 2024 | Covered |
|---|
| Policy | Effective | Status of D05.00 |
|---|---|---|
| Breast Procedures; including Reconstructive Surgery, Implants and Other Breast Procedures | Jul 1, 2026 | Covered |
| Compression Devices for Lymphedema | Jan 6, 2026 | Covered |
| Cosmetic and Reconstructive Services: Skin Related | Jan 6, 2026 | Covered |
| Mastectomy for Gynecomastia | Apr 15, 2026 | Covered |