Follow these guidelines for billing genetic testing

When billing for genetic testing, keep the following policy guidelines in mind:

• Individual carrier screening procedure codes may receive a denial when a single comprehensive code is more appropriate.
• BRCA1 and BRCA2 genetic testing should be billed with the appropriate diagnosis and for the appropriate patient age.
• Lynch syndrome genetic testing may receive a denial when microsatellite instability analysis or immunohistochemistry testing hasn’t been billed in the previous 30 days.
• BRCA gene variant combinations should be billed with appropriate diagnosis codes.
• Cystic fibrosis transmembrane conductance regulator, or CFTR, gene variant combinations should be billed with appropriate diagnosis codes.
• Genetic analysis for non-invasive prenatal screening testing for fetal aneuploidy should be billed with appropriate diagnosis codes.
• Gap junction beta 2, or GJB2, gene variant combinations should be billed with appropriate diagnosis codes.

If you think the services rendered warrant an exception, follow the current clinical editing appeals process.