Referring Providers

Indications for Referral for Genetic Testing/Counseling

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 [email protected]  

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 [email protected]. 

• 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