MolDX: Oncotype DX® Breast Cancer for DCIS (Genomic Health™)

This policy provides limited coverage for the Oncotype DX DCIS assay for women with ductal carcinoma in situ who are planning breast-conserving surgery and are considering adjuvant radiation therapy. Coverage is restricted to that clinical scenario; the policy does not specify documentation, prior authorization, or frequency limits and other uses are not addressed here.

"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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