Policy Updates Prior AuthorizationMedicaid Managed CareApril 1, 2024

Prior authorization for pharmacogenomic testing

Effective May 1, 2024, prior authorization rules will be applied to pharmacogenomic testing. The medical policy and clinical guideline that will be applied to pharmacogenomic testing is GEN09-0223.1. Providers may access the clinical policy here.

Code

Description

0345U

Psychiatry (For example, depression, anxiety, attention deficit hyperactivity disorder ADHD), genomic analysis panel, variant analysis of 15 genes, including deletion/duplication analysis of CYP2D6.

Anthem Blue Cross and Blue Shield Medicaid is the trade name of Community Insurance Company. Independent licensee(s) of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

OHBCBS-CD-051428-24

PUBLICATIONS: April 2024 Provider Newsletter