LAB.00026 Systems Pathology and Multimodal Artificial Intelligence Testing for Cancerous and Precancerous Conditions

This policy addresses systems pathology and multimodal artificial intelligence laboratory tests for cancer risk assessment, specifically the ArteraAI Prostate risk stratification test. Coverage is medically necessary only for ArteraAI to inform shared decision-making in individuals with localized, nonmetastatic prostate cancer classified as low- or intermediate-risk, and who have not received prostate radiation therapy or androgen deprivation therapy prior to biopsy. All other uses of systems pathology or multimodal AI tests, including for Barrett’s esophagus, are considered investigational and not medically necessary.

"Use of the ArteraAI Prostate cancer risk stratification test is consideredmedically necessaryto inform shared decision-making regarding treatment options whenALLof the following are met:"

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