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local coverage determination

A bi-weekly listing of recent local coverage determinations from Medicare Administrative Contractors for Guardant Health, Natera, Transplant Genomics, and More for the week of 4/26/19.

A bi-weekly listing of recent local coverage determinations from Medicare Administrative Contractors for Prospera, Noridian, CGS, and more for the week of 4/12/2019.

A bi-weekly listing of recent local coverage determinations from Medicare Administrative Contractors. 

The Medicare contractor said in its draft guidance it would provide limited coverage for the cell-free DNA assay, which should be used as a supplemental test.

Medicare contractor Palmetto is proposing to expand coverage to ensure that more patients have access to genomic profiling when tissue-based testing is not possible.

CMS had received significant stakeholder feedback that germline NGS testing is not the same as somatic testing, and that the NCD as written would negatively impact patients.

Palmetto's MolDx has agreed to cover Myriad's MyPath Melanoma to help rule out the disease when the biopsy can't be definitively classified by standard clinical and histopathological characteristics.

The agency said it is sensitive to stakeholder concerns and is working with MACs to adjust claims processing systems.

The test is designed to determine which early-stage, estrogen receptor-positive breast cancer patients are likely to benefit from extended endocrine therapy.

The ctDNA test will be covered for all US fee-for-service Medicare patients with advanced (Stage IIIB/IV) NSCLC who meet specific clinical criteria.

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