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

This policy covers molecular diagnostic assays and breath testing for detection and monitoring of transplant rejection, including dd‑cfDNA assays, gene‑expression profiling, CD154+ T‑cell assays, blood group genotyping, and breath methylated alkane contour (BMAC) testing. It applies to transplant recipients (heart, kidney, liver, lung and select pediatric allografts) but notes biopsy remains the diagnostic gold standard, many tests are described as adjunctive or investigational, and some assays (eg, Heartsbreath/BMAC) are limited to narrow use criteria such as adjunctive use with a recent endomyocardial biopsy for suspected grade‑3 heart rejection within one year post‑transplant.

"No explicit limitations, exclusions, frequency limits, or organ-specific restrictions are provided in the supplied excerpt."

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