MolDX: MGMT Promoter Methylation Analysis

MGMT promoter methylation analysis is covered for adult patients (age >=18) with high-grade malignant glioma (e.g., glioblastoma multiforme, anaplastic astrocytoma) when the patient can tolerate temozolomide or radiation and the treating physician will use results to guide first-line adjuvant therapy choices. Coverage is conditional on the expectation that adjuvant therapy is potentially beneficial; the policy does not list specific claim forms or frequency limits and excludes testing for non-high-grade glioma and pediatric patients.

"MGMT promoter methylation analysis is covered for adult patients (age >=18) with a tumor histology of high-grade malignant glioma, such as glioblastoma multiforme or anaplastic astrocytoma."

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