LCDActive
MolDX: Oncotype DX® Breast Cancer for DCIS (Genomic Health)
L36912
Effective: November 25, 2021
Updated: December 31, 2025
Policy Summary
The Oncotype DX DCIS assay is covered only for women with ductal carcinoma in situ who plan to undergo breast-conserving surgery and are contemplating adjuvant radiation therapy. The policy provides limited coverage restricted to this clinical scenario; no additional documentation, frequency limits, or other indications are specified in the provided excerpt.
Coverage Criteria Preview
Key requirements from the full policy
"Oncotype DX DCIS assay is covered for women diagnosed with ductal carcinoma in situ (DCIS) who are planning breast-conserving surgery and are considering adjuvant radiation therapy."
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