Indications for Referral
If your patient has a personal or close family history of any of the following, referral for genetic counseling is indicated:
- Epithelial ovarian cancer, including fallopian tube or peritoneal cancer, at any age
- Exocrine pancreatic cancer at any age
- Metastatic or intraductal prostate cancer at any age
- Male breast cancer at any age
- Colon or uterine cancer that is MSI-high or with loss of mismatch repair staining (not explained by MLH1 promoter hypermethylation or BRAF mutation) at any age
- Breast, colon, or uterine cancer diagnosed under age 50
- Triple negative breast cancer diagnosed at age 60 or younger
- Ashkenazi Jewish ancestry with breast and/or high-grade prostate cancer at any age
- Multiple relatives on the same side of the family with breast, colon, uterine, melanoma, and/or prostate cancers
- Colon polyposis (10+ adenomas) or rare polyps (2+ hamartomas or any number of Peutz-Jegher type polyps or juvenile polyps)
- Certain rare cancers at any age including:
- Medullary thyroid cancer
- Paraganglioma/pheochromocytoma
- Adrenocortial carcinoma
- Lhermitte-Duclos disease
- Known pathogenic mutation in the family in a cancer predisposition gene
- Tumor genomic testing identifying a possible germline pathogenic mutation
As this list is not exhaustive, if you are unsure whether your patient is appropriate for genetic counseling and/or testing, please send us an eConsult (UCLA Health providers only) or email us at cancergenetics@mednet.ucla.edu
Please click here for more information about eConsults.
How to Refer your Patient
Adult Cancer Genetics
UCLA Health Providers
In CareConnect, please enter a "Referral to Genetics, Cancer Adult"
- For patients with an HMO, including UCLA Medical Group, prior authorization of CPT 96040 x3 units is required.
- For patients with managed Medi-Cal plans, Medicare Advantage or Tricare, please use CPT 99205. Please note that not all offices accept these plans for genetic counseling.
- Most PPO plans do not require prior authorization for genetic counseling.
- Tip Sheet - Referrals to Cancer Genetic Counseling.pdf
Outside Providers
Please fax your referral with all relevant medical records to 310-825-5136 or email to cancergenetics@mednet.ucla.edu.
- For patients with an HMO, prior authorization of CPT 96040 x3 units is required.
- For patients with managed Medi-Cal plans, Medicare Advantage or Tricare, please use CPT 99205. Please note that not all offices accept these plans for genetic counseling.
- Most PPO plans do not require prior authorization for genetic counseling.
- For a list of all insurance plans accepted at UCLA, please click here.
Pediatric Cancer Predisposition Program
UCLA Health Providers
In CareConnect, please enter a "Referral for Genetics and Pediatric Hematology-Oncology"
Outside Providers
Please call 310-825-6708
