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Special Provider Bulletin - Laboratories (B2000443 - 01/2020)

Colorado Medicaid·CO·Provider Bulletin
Effective date
Feb 10, 2020
We identified it
Jun 20, 2026
Days to comply

Summary

Effective February 10, 2020, 32 specific genetic testing codes now require prior authorization for Laboratory, Physician Services and Hospital Providers. This is part of a phased implementation that will eventually cover all genetic testing codes 81170-81599.

Action Required

Action needed
Before February 10, 2020: Billing team must update system to require prior authorization for all 32 listed genetic testing codes through ColoradoPAR website. Providers must obtain prior auth before ordering these tests. Laboratory staff must verify authorization before processing. Claims without prior authorization will be denied.

Affected Billing Codes

81200
81209
81220
81241
81243
81251
81255
81256
81257
81260
81283
81290
81293
81294
81295
81296
81297
81298
81299
81300
81318
81319
81323
81327
81380
81400
81401
81402
81406
81407
81420
81432