S3849 Gene test niemann-pickGenetic testing for niemann-pick disease
Status I: not valid for Medicare (Medicare uses another code).
2 of 2 payer prior-auth lists that name S3849 require prior authorization or set conditions: Blue Cross and Blue Shield of Texas, Humana.
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| Blue Cross and Blue Shield of Texas | Texas PA exemption (gold card), outpatient, fully insured | TX | prior auth required | Gold-card exemption available | Apr 1, 2024 | BCBSTX Outpatient Prior Authorization Exemption Clinical Guidelines (max units, PA exempt date range) |
| Humana | Oak Street Health | All | prior auth required | Oak Street Health (Humana): Prior Authorization List (PAL) Codes Under Management |
S3849 appears in 6 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi, Blue Cross Blue Shield of Massachusetts, Regence.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Invasive Prenatal Diagnosis of Genetic Diseases (0358) | listed, no stance (range S3841-S3853) | May 22, 2026 | payer document |
| Aetna | Recurrent Pregnancy Loss (0348) Other HCPCS related to the CPB | covered if criteria are met (range S3800-S3870) | Jun 23, 2026 | payer document |
| Blue Cross & Blue Shield of Mississippi | Genetic Testing (L.2.04.409) | covered if criteria are met | payer document | |
| Blue Cross Blue Shield of Massachusetts | Carelon Genetic Testing Management Program CPT and HCPCS Codes (957) | listed, no stance | payer document | |
| Regence | Genetic and Molecular Diagnostic Testing (Genetic Testing 20) | listed, no stance | Apr 1, 2025 | payer document |
| Regence | Reproductive Carrier Screening for Genetic Diseases (Genetic Testing 81) | listed, no stance | Oct 1, 2025 | payer document |
Prior authorization required or conditional in IN.
From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.