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81167 - CPT codes removed

This procedure appears on the selected insurer prior authorization source.

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Procedure / ServiceCPT codes removed
Procedure / Service Description

replaced by updated CPT code list and no longer includes ICD 10 codes. Clinical - 12/31/23 Utilization Management Committee approval 11/9/23 CPT 81432 removed from Table 2 Noncovered codes, added to Table 1 covered codes. CPT codes removed, 81162, 81163, 81164, 81165, 81166, 81167, 81212, 81215, 81216, 81217; refer to Genetic Testing: BRCA-Related Breast and/or Ovarian Cancer Syndrome MNG.

Likely documents
  • Confirm benefit details
  • Submit clinical notes if requested by the plan
Next actions
  • Confirm the current plan policy before submission.
  • Use the insurer authorization workflow for this listed code.