Molecular Markers in Fine Needle Aspirates of Thyroid Nodules - Medicare Advantage

This policy covers molecular diagnostic testing of fine-needle aspiration (FNA) specimens from thyroid nodules (e.g., Afirma, ThyroSeq, ThyGeNEXT/ThyraMIR) for risk stratification to inform clinical management. It is intended primarily for patients with indeterminate FNA cytology (Bethesda indeterminate categories) when results may alter surgical or follow-up decisions, is limited to FNA specimens (not for definitively benign or malignant cytology), and is subject to local MAC/LCD/LCA coverage and medical necessity requirements, with additional justification often needed when testing multiple nodules.

"No frequency limits, age restrictions, or explicit exclusions are stated in the provided text."

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