Payer PolicyActive
LAB.00025 Topographic Genotyping
ANTHEM-LAB.00025
Anthem
Effective: April 16, 2025
Updated: December 30, 2025
Policy Summary
This policy addresses topographic genotyping (e.g., PathFinderTG platform tests such as PancraGEN, BarreGEN, and RespriDX) that integrate anatomic pathology with molecular mutational analysis. Anthem considers topographic genotyping investigational/experimental and not medically necessary; therefore, it is not covered for any indication. Noncoverage applies in all clinical scenarios, including when histology or cytology is inconclusive, and related claims (e.g., CPT/HCPCS 81479, 84999, 89240) will be denied.
Coverage Criteria Preview
Key requirements from the full policy
"Topographic genotyping is consideredinvestigational and not medically necessaryfor all indications."
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