Billing and Coding: MolDX: Minimal Residual Disease Testing for Solid Tumor Cancers

This policy covers specific MRD assays (tumor‑informed and tumor‑naïve) for defined indications including diagnosis of recurrence/progression and monitoring ICI response in selected solid tumors when clinical validity criteria are met. Coverage requires registration with the DEX system and submission of the assigned DEX Z‑Code, appropriate ICD‑10 diagnosis (including 'personal history of cancer' where applicable), and adherence to unit‑of‑service limits (generally 1 UOS; once per diagnosis for patients with cancer; ≤1 per month for patients without active cancer) and subsequent tests only when genetic change is documented per NCD 90.2.

"For patients with cancer, initial MRD testing using tumor‑informed (tumor‑profiled) assays is covered for the listed tests including Signatera Bespoke Assay Design + Plasma Series Bundle, RaDaR Bes..."

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