Genetic and Coagulation Testing for Noncancer Blood Disorders - Medicare Advantage

This Medicare Advantage policy covers genetic and coagulation testing for noncancer blood disorders, including molecular diagnostic assays for hemoglobinopathies/thalassemia, thrombophilia/hypercoagulability testing (e.g., Factor V Leiden, prothrombin F2 G20210A, MTHFR), DNA-based blood product antigen typing, and multigene panels/pharmacogenomics relevant to transfusion and clotting disorders. Testing is intended for patients with suspected or diagnostic indications (e.g., venous thrombosis, recurrent clotting, suspected hemoglobinopathies) and is subject to medical necessity and the referenced MolDX LCDs/LCAs and ACMG standards; routine population screening—particularly MTHFR polymorphism testing—is not supported and specific coverage criteria and exclusions must be confirmed in the cited LCDs.

"Molecular pathology and genetic testing matters referenced under LCD L35062 (Biomarkers Overview; Molecular Pathology and Genetic Testing)"