Lab: Flow Cytometry

Flow cytometry is covered for evaluation and immunophenotyping of hematolymphoid and selected non-hematolymphoid disorders (eg, lymphomas, acute leukemia, CLL, plasma cell disorders, MDS, CMPD, PNH, MRD, HIV monitoring, transplant monitoring, platelet disorders, select carcinomas, molar pregnancy, and primary immunodeficiencies) using appropriate panels on blood, bone marrow and other tissues. Routine panels are limited to 24 markers; any markers beyond 24 require specific, documented clinical justification for each additional marker or claims will be denied. Required documentation includes the FCM report justification for >24 markers, WBC differential for absolute CD4 calculation in HIV, and documentation of prior laboratory review when invasive procedures are performed for unexplained cytopenias.

"FCM is indicated to evaluate blood, body fluids, CSF, bone marrow, lymph node, tonsil, spleen and other solid tissues for characterization of cellular populations and to avoid more invasive procedu..."