How does eviCore handle large gene panels?

Most panels require prior authorization. When panels are billed with individual codes for the genes in a panel, eviCore reviews the medical necessity of each gene within a panel and typically only prior authorizes and recommends reimbursement for those genes that are medically necessary. In addition, many panels now have a panel-specific CPT code, but some labs are still billing with multiple stacked CPT codes. eviCore helps ensure our clients only pay claims that appropriately coded.

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