P2P Call Guide

How to Win a P2P Call for Genetic / Genomic Testing Denied by MA Plans

Payer-specific strategy, medical necessity arguments, and the exact phrases to use when Medicare Advantage denies Genetic / Genomic Testing (CPT 81479, 81455, 81432).

Why MA Plans Denies Genetic / Genomic Testing

Test not considered medically necessary for this diagnosis

Does not meet hereditary cancer testing criteria

Results will not change treatment plan

Know Medicare Advantage's Criteria

Medicare Advantage plans must cover all services covered by Original Medicare (CMS NCDs and LCDs) but may require prior auth. Plans use various criteria including InterQual, MCG, and proprietary guidelines.

Key policies to know:

  • Must cover all services covered by Original Medicare
  • Can require prior authorization not required by Original Medicare
  • CMS NCDs and LCDs serve as coverage floor
  • Organization determinations must be issued within 14 days (72 hours for expedited)

Building Your Medical Necessity Argument

Document how test results will directly change management

Meet NCCN testing criteria (family history, age, tumor type)

Reference specific actionable mutations being tested

Note FDA-approved companion diagnostics if applicable

P2P Call Tips for MA Plans

Cite the relevant CMS NCD or LCD -- MA plans cannot deny what Medicare covers

If the service has a CMS NCD, that trumps the MA plan's internal criteria

Reference CMS regulations on MA coverage obligations

Request expedited determination if clinical urgency exists

Guidelines to Reference

  • NCCN Genetic/Familial High-Risk Assessment Guidelines
  • CMS NCD for Next Generation Sequencing

Relevant CPT Codes

CPT 81479CPT 81455CPT 81432

Specialty: Oncology / Medical Genetics

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