LAB.00015 Detection of Circulating Tumor Cells

This policy addresses detection of circulating tumor cells (CTCs) in blood for cancer management, including assays such as the CellSearch System. Anthem deems CTC testing investigational and not medically necessary; it is not covered for any indication (including monitoring metastatic breast, colorectal, or prostate cancer), with no covered exceptions—applying across all cancer types and stages and to related billing codes (e.g., 86152, 86153, L38584, S0500, S3711).

"Detection of circulating tumor cells in the blood is consideredinvestigational and not medically necessaryin the management of individuals with cancer."

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