News


Cigna Updates Genetic Testing Policy

After extensive and positive discussions between CIGNA and the leadership of ASBrS, we are pleased to let you know that the previous CIGNA policy requiring consultation with an independent genetic counselor prior to the ordering of genetic testing has been changed.  The new policy, which became effective January 15th, exempts breast surgeons who are ordering genetic testing where the results of testing will influence surgical decision making in an individual recently diagnosed with early stage breast cancer.

Surgeons who plan to order their own testing will be asked to: 

  • Evaluate the patient
  • Perform a three-generation pedigree [This can be accomplished via Mastery of Breast Surgery Risk Calculator available to you for free as a member]
    and
  • For a patient with recently diagnosed breast cancer, refer to an appropriately credentialed independent genetic counselor for post-test counseling

Panel testing or single gene testing is allowed, so long as the lab is contracted with CIGNA for those tests.  Please consult with them for the most up to date list of approved providers of testing.

This represents a positive step forward for CIGNA in their recognition of surgeons' capabilities in this field and for balancing the need for rapid testing by patients awaiting surgery to affect the best patient care with appropriateness in testing.  We will continue to engage with CIGNA and other payers on issues that affect our patients and practices.  

Full policy can be found here:  https://cignaforhcp.cigna.com/public/content/pdf/coveragePolicies/medical/mm_0518_coveragepositioncriteria_genetic_cancer_syndromes.pdf.

Please feel free to contact Mena Jalali at mjalali@breastsurgeons.org with issues that you may encounter or with questions.