As we informed you in mid-June, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) moved the review of BRCA 1 and BRCA 2 testing from post-service to pre-service review as of July 1, 2015, to improve the member and physician experience when ordering these tests.
In order to assist providers with the submission of their prior review requests for BRCA 1 and BRCA 2 genetic testing for breast cancer, we've added a new "Request Type" called "BRCA Genetic Testing" to the Blue eSM online authorization requests section. If you're a registered Blue e user, just log into the Blue e system to complete the BRCA assessment, which will automatically be sent to a nurse for prior review. Instructions for submitting the assessment are available for your reference in Blue e's "Resources" section.
Breast Cancer 1 & 2 (BRCA 1 and BRCA2) genetic mutations are associated with a significantly higher risk for breast and ovarian cancer. BRCA testing is an important screening tool and should be performed on those members who meet clinical criteria for coverage.