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    v1.0.30
    OpenPayerPolicy UpdatesGenetic & Molecular TestingBCBS Rhode Island Nodule Testing Update | OpenPaye…
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    CurrentBlue Cross Blue Shield - Rhode IslandPolicy N/A

    Molecular Testing in the Management of Pulmonary Nodules

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    This policy addresses the use of molecular tests in the diagnostic workup and risk stratification of pulmonary nodules for Blue Cross Blue Shield of Rhode Island commercial and Medicare Advantage products. The current policy no longer addresses the REVEAL Lung Nodule Characterization test.

    Policy Summary
    PayerBlue Cross Blue Shield - Rhode Island
    PolicyMolecular Testing in the Management of Pulmonary Nodules
    Policy CodePolicy N/A
    Change TypeRemoval
    Effective DateNov 1, 2026
    Last ReviewJul 1, 2026
    Next Review DateN/A
    Key ActionRefer to the Related Policies section for REVEAL Lung Nodule Characterization by MagArray.
    SourceLink
    POLICY UPDATE CHANGES

    REVEAL Lung Nodule Characterization by MagArray is no longer addressed in the policy.

    1Molecular test removed
    0092UCPT code no longer addressed

    OpenPayer is powered by Trek Health's payer performance platform. Trek continuously ingests, validates, and normalizes Transparency in Coverage data alongside payer policies and other commercial payer data to create a structured payer intelligence foundation. OpenPayer uses this foundation to deliver personalized search results, dynamically generated policy pages, and tailored policy monitoring based on each user's payers, specialties, billing codes, and areas of interest. The same intelligence powers broader payer performance workflows, including reimbursement benchmarking, contract evaluation, payer negotiations, and financial decision-making.

    3
    Invasive procedure types discussed

    Coding Information

    REVEAL Lung Nodule Characterization — no longer addressedCPT
    0092UOncology (lung), three protein biomarkers, immunoassay using magnetic nanosensor technology, plasma, algorithm reported as risk score for likelihood of malignancy

    Clinical Background

    Pulmonary nodules may require invasive diagnostic procedures to evaluate for malignancy, including CT-guided biopsy, bronchoscopy, or video-assisted thoracoscopic procedures. These procedures may cause complications such as post-procedure pain or pneumothorax; plasma-based proteomic screening and gene expression profiling from bronchial brushing have been proposed to help risk-stratify patients and determine whether subsequent invasive evaluation is needed.

    Policy Summary
    PayerBlue Cross Blue Shield - Rhode Island
    PolicyMolecular Testing in the Management of Pulmonary Nodules
    Policy CodePolicy N/A
    Change TypeRemoval
    Effective DateNov 1, 2026
    Last ReviewJul 1, 2026
    Next Review DateN/A
    Key ActionRefer to the Related Policies section for REVEAL Lung Nodule Characterization by MagArray.
    SourceLink
    On This Page
    Coding InformationClinical Background