At the request of Idaho Medicaid, and to streamline the process for reviewing genetic tests, all genetic codes except the following will be reviewed by Telligen effective Monday, March 12th, 2018:

  • 81225  Cyp2c19 gene analysis common variants;
  • 81226  cyp2d6 gene analysis common variants;
  • 81227  cyp2c9 gene analysis common variants;
  • 81230  Gene analysis (cytochrome P450 family 3 subfamily A member 4) for common variant;
  • 81231  Gene analysis (cytochrome P450 family 3 subfamily A member 5) for common variant; and
  • 81355  vkorc1 gene analysis common variants. 

In order to ensure a smooth transition with this new process, the Division of Medicaid’s Medical Care Unit will redirect providers to the Qualitrac portal where they can submit genetic testing requests to Telligen.  This redirection and notice will be sent to the submitting provider until April 1st, 2018, at which point submission through Telligen should be considered the standard method of submitting requests.

An updated list of codes requiring Telligen review can be found here

As always, Telligen’s Idaho Medicaid page is a source of current information regarding the reviews Telligen conducts on behalf of Idaho Medicaid.