LAB.00033 Protein Biomarkers for the Screening, Detection and Management of Prostate Cancer

- Service addressed: Blood- or urine-based protein biomarker laboratory tests used for the screening, detection, risk stratification, or management of prostate cancer (e.g., assays billed under 81479, 81539 and related L-codes). - Coverage determination: Anthem considers these tests investigational/experimental and not medically necessary; therefore, they are not covered. - Key limitations: There are no covered indications—noncoverage applies to all clinical scenarios and assay types (screening, diagnosis, risk stratification, and monitoring).

"The use of protein biomarker tests for the screening, detection, and management of prostate cancer is consideredinvestigational and not medically necessary."

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