LAB.00011 Selected Protein Biomarker Algorithmic Assays

This policy addresses selected protein biomarker algorithmic assays, specifically BDX-XL2 (Nodify XL2), EarlyCDT-Lung (Nodify CDT), IMMray PanCan-d, and LC-MS/MS targeted proteomic assays. These tests are considered investigational/experimental and not medically necessary, and therefore are not covered for all indications (including screening, diagnosis, prognosis, or treatment decision-making). There are no covered exceptions or conditions; related codes (e.g., 81538, 81599, 83519, 83520, 84999, 86255, 86256) are not covered.

"The following protein biomarker algorithmic assays are consideredinvestigational and not medically necessaryfor all indications:"

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