Flow Cytometry - (0538)

Flow cytometry is covered as medically necessary for evaluation of hematopoietic/hematologic cancers, immunodeficiency disorders (including HIV/AIDS), paroxysmal nocturnal hemoglobinuria, gestational trophoblastic disease, and transplant-related indications, but is not covered for all other indications (including DNA ploidy/proliferation assessment in solid tumors). Claims must use appropriate covered diagnosis and current CPT/ICD procedure codes to be reimbursable and may be reviewed or denied by medical directors based on benefit terms and clinical judgment.

"Flow cytometry is considered medically necessary for the evaluation of any of the following: Hematopoietic/hematologic cancers; Immunodeficiency disorders, including human immunodeficiency virus (H..."

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