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The contractors will provide limited coverage for ctDNA tests if the patient has a personal history of stage II to stage III colorectal cancer.
The Medicare Administrative Contractor will cover ctDNA tests if the patient has a personal history of colorectal cancer.
In a local coverage article, Medicare contractors in the MolDx program added prostate cancer to the covered indications for the test.
The classifiers are considered reasonable and necessary if the patient can tolerate chemotherapy and it's being considered as a treatment for the patient.
The MAC will consider PGx testing reasonable and necessary after a physician has narrowed a patient's treatment options to specific medications.
A bi-weekly listing of recent local coverage determinations from Medicare Administrative Contractors.
Under the LCD, pharmacogenomic tests are covered when medications are being considered for use that are known to have a clinically actionable gene-drug interaction.
The decision comes after Myriad requested expanded coverage for women with breast cancer seeking information about extending endocrine therapy.
The Medicare Administrative Contractor's decision covers molecular diagnostic laboratory tests as predictive classifiers for non-small cell lung cancer.