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Molecular Pathology

Molecular pathology services, including genetic testing, are rapidly becoming the standard of care in diagnostic medicine and other related areas. OHCA is committed to ongoing evaluation of the clinical evidence supporting the use of these services to ensure that medically necessary tests and technologies are available to our members.

Molecular Pathology Testing Coverage and Guidelines

Frequently Asked Questions


Prior Authorization

Provider Letters and Messages

  • 6/26/2018: Prior Authorization for Gene Expression Profiling CPT Code
  • 3/22/2018: Prior Authorization for Microarray Effective 5/1/2018
  • 9/18/2017: Prior Authorization for Cystic Fibrosis Common Mutation Testing
  • 7/31/2017: Molecular Pathology Prior Authorization - Effective September 1, 2017
  • 7/28/2016: Prior Authorization of Hereditary Cancer Susceptibility Testing
  • 1/6/2016: Non-Invasive Prenatal Testing for High-Risk Pregnant Women 
  • 12/1/2015: Prior Authorization of 2016 Molecular Pathology Codes
  • 9/30/2015: Prior Authorization of Molecular Pathology Codes: HLA Typing
  • 5/29/2014: Prior Authorization of Molecular Pathology Codes
  • 8/8/2013: Coverage of Carrier Screening
  • 7/8/2013:  Amendments to Genetic Testing and Counseling Policy
  • 4/8/2013:  Cell-Free Fetal DNA Testing aka Non-Invasive Prenatal Testing (NIPD)
  • 1/14/2013:  Billing for Molecular Pathology Codes
  • 2/7/2013:  Infectious Agent Detection by Nucleic Acid
  • 12/27/2012:  Molecular Pathology CPT Coding Changes and Prior Authorization



On the OHCA proposed rule changes page, there is a sign up button for Web Alerts. These Web Alerts will send an email notification when there is a new posting for a proposed rule change. With each posting on this page, there is an opportunity to complete an electronic feedback form.

The OHCA seeks advice and consultation from medical professionals, professional and tribal organizations, and the general public in developing new or amended policies and rules. The proposed rule changes page is designed to give all constituents an opportunity to review and make comments regarding upcoming rule changes.

Disclaimer: The OHCA rules found on this Web site are unofficial. The official rules are published by the Oklahoma Secretary of State Office of Administrative Rules as Title 317 of the Oklahoma Administrative Code. To order an official copy of these rules, contact the Office of Administrative Rules at (405) 521-4911.


Last Modified on May 01, 2023