CommercialCoverageMedium impact
Policy Criteria Change
Arkansas Blue Cross Blue Shield·AR · Oncology, Urology, OB-GYN·Medical Policy
Effective date
Jan 1, 2026
We identified it
Jun 19, 2026
Summary
Arkansas Blue Cross is archiving several older medical policies and updating two biomarker testing policies for breast and prostate cancer. The most significant changes add restricted coverage for liquid biopsy testing (ctDNA) with specific criteria for both cancer types.
Action Required
By January 1, 2026: Billing team must update system to recognize new coverage criteria for liquid biopsy tests (codes 0239U and 0242U) for breast and prostate cancer patients. Update prior authorization workflows to verify patients meet all specified criteria including cancer staging, prior testing history, and tissue availability. Remove archived policies from reference materials.