LCDActive
MolDX: MGMT Promoter Methylation Analysis
L35974
Effective: October 14, 2021
Updated: December 31, 2025
Policy Summary
MGMT promoter methylation testing is covered for adult patients with pathologically confirmed high-grade malignant glioma when the patient can tolerate temozolomide or radiation and when the treating physician will use the result to inform first-line adjuvant therapy choice (radiation vs chemotherapy or temozolomide vs other chemotherapy). Testing is limited to situations where results will change initial adjuvant treatment decisions and is not covered for non–high-grade glioma, pediatric patients, patients who cannot tolerate therapy, or when the result will not affect treatment.
Coverage Criteria Preview
Key requirements from the full policy
"MGMT promoter methylation analysis is covered for adult patients (age >=18) with a tumor histology of high-grade malignant glioma (e."
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