RET Proto-Oncogene Testing

Aetna covers germline RET mutation testing as medically necessary only for high‑risk members — those with a first‑degree relative with medullary thyroid carcinoma, first‑ or second‑degree relatives with a known germline RET mutation (targeted testing for the familial mutation), individuals with C‑cell hyperplasia, or individuals with two or more endocrine tumors. Testing is experimental/investigational and not covered for all other indications (e.g., non‑small cell lung cancer) and specific HCPCS/ICD‑10 codes are listed as not covered (S3840; C34.00–C34.92, C75.5, D35.6).

"Documentation of genetic counseling (recommendation/notes) prior to testing and evidence that testing is being used to guide clinical management (e."

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