Does C50.122 require prior authorization?

No, C50.122 does not require prior authorization (high confidence). Code is covered without prior authorization.

`C50.122` — Malignant neoplasm of central portion of left male breast

ICD-10-CM

No Prior Auth Required

Code is covered without prior authorization (high confidence)

Enter '1' in the Days/Unit field on the claim when billing for MammaPrint®.
For CPT non-NOC codes, submit required information using SV101-7 or SV202-7 (preferred) or the NTE field.
Enter the appropriate DEX Z-Code™ identifier adjacent to the CPT code in the comment/narrative field for Part B claims (Loop 2400 or SV101-7 for 837P; Box 19 for paper claims).
Enter the appropriate DEX Z-Code™ identifier adjacent to the CPT code in the comment/narrative field for Part A claims (Line SV202-7 for 837I electronic claim; Block 80 for UB04).

MammaPrint® is indicated to analyze gene expression of FFPE breast cancer tissue to assess a patient's risk for distant metastasis (early-stage breast cancer).
The test may be performed using either the FDA-cleared microarray assay or a next-generation sequencing (NGS)-based assay.
PIK3CA targeted gene sequencing is indicated to detect PIK3CA mutations in patients with hormone receptor (HR)-positive, HER2-negative, advanced or metastatic breast cancer (postmenopausal women and men) who have progressed on or after an endocrine-based regimen when results will inform treatment with alpelisib (Piqray).
Oncotype DX Breast is intended for patients with estrogen-receptor (ER) positive micrometastases of carcinoma of the breast.
Oncotype DX Breast is intended for patients with estrogen-receptor (ER) positive breast carcinoma with 1–3 positive lymph nodes.
Oncotype DX Breast is intended for patients with estrogen-receptor (ER) positive, node-negative invasive carcinoma of the breast.

L38835 — MolDX: Minimal Residual Disease Testing for Cancer

J05

L38158 — MolDX: Next-Generation Sequencing for Solid Tumors

J05

A60309 — Billing and Coding: MolDX: Non-Next Generation Sequencing Targeted Molecular Panel Tests for Predictive Testing in Cancer

J05

L34648 — Bisphosphonate Drug Therapy

J05

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