LAB.00003 In Vitro Chemosensitivity Assays and In Vitro Chemoresistance Assays

This policy addresses in vitro chemosensitivity and chemoresistance assays used to select chemotherapy for cancer, including tests such as Histoculture Drug Response Assay, fluorescent cytoprint, ChemoFX, and CorrectChemo/MiCK. These assays are considered not medically necessary and are not covered for all indications, including extreme drug resistance assays. This noncoverage applies regardless of cancer type, clinical context, or assay brand/method, and includes services billed under CPT/HCPCS codes 81535, 81536, 86849, 87999, and 89240.

"In vitro chemosensitivity assays, as a guide to selection of chemotherapeutic drugs for individuals with cancer, are considerednot medically necessaryfor all indications."

Sign up to see full coverage criteria, indications, and limitations.