Genomic Sequence Analysis Panels in the Treatment of Hematolymphoid Diseases
L37606
Genomic Sequence Analysis Panels are covered for evaluation of blood or bone marrow in specified hematolymphoid conditions including newly diagnosed or relapsed/refractory AML (when patients are candidates for treatment or transplantation as specified), diagnostically unclear MDS/MDS-MPN and MPN (with CML excluded by BCR-ABL1 negative), intermediate-risk MDS per IPSS/IPSS-R, PMF risk stratification when not already high-risk by DIPSS Plus, and monitoring higher-risk myelofibrosis with progression on therapy. Required documentation includes nondiagnostic clinical/lab/pathology assessments when applicable, IPSS/IPSS-R/DIPSS Plus risk scores, evidence of treatment or transplantation candidacy for AML cases, and BCR-ABL1 negative test results to exclude CML. Repeat testing is allowed for MDS after initial diagnosis/risk stratification and for MF with progression, but the policy excerpt does not specify numeric frequency limits.
"Genomic Sequence Analysis Panel is covered for newly diagnosed acute myelogenous leukemia (AML) patients who are candidates for treatment, regardless of karyotype findings."