Molecular Diagnostic Assays and Breath Testing for Transplant Rejection - MEDICAID - FLORIDA

This policy addresses molecular diagnostic assays (for example, donor-derived cell‑free DNA, gene expression profiling/microarray and other RNA/DNA-based tests) used to detect or monitor transplant rejection in solid‑organ transplant recipients—primarily kidney and heart (with references to lung and other allografts). Major limitations are that numerous specific tests are deemed investigational or have insufficient evidence and are not established as covered (breath testing is not covered), and the excerpt provides no explicit coverage criteria, CPT/HCPCS codes, frequency limits, age restrictions, or prior‑authorization requirements.

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