Genetic Testing for Hematologic Malignancies and Suspected Myeloid Disorders - Medicare Advantage

This policy covers genetic testing for hematologic malignancies and suspected myeloid disorders — including targeted 3–5 gene NGS panels and specified assays (eg, NRAS, ASXL1, TP53, BCR‑ABL, IDH1/2) and lab‑developed NGS tests used in diagnosis and management of conditions such as myelodysplastic syndromes, acute myeloid leukemia, BCR‑ABL‑negative myeloproliferative neoplasms, and splenic marginal zone lymphoma in Medicare Advantage members. Coverage is limited to indications and tests that meet MolDX/MAC LCD/LCA/NCD medical‑necessity, analytic and clinical‑validity/utility criteria within the applicable MAC jurisdiction; broad genomic panels including genes not relevant to the patient’s hematolymphoid disease or tests lacking demonstrated validity/utility are not covered.

"CCND3 Gene Testing"

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