Bladder/Urothelial Tumor Markers

Bladder tumor markers are covered only as adjunctive tests performed in conjunction with cystoscopy (and urine cytology for surveillance) to evaluate symptomatic patients or to monitor patients with known urothelial carcinoma for recurrence or progression. Markers are not covered for routine screening of asymptomatic patients or all patients with hematuria, must be used after other diagnostic studies fail to identify an etiology, and a set list of other assays is considered investigational and not covered.

"Bladder tumor marker testing is covered when performed in conjunction with cystoscopy to evaluate patients with signs or symptoms suggesting bladder cancer (eg, gross or persistent hematuria)."

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