MDS FISH

FISH testing for MDS is covered only when bone marrow exam suggests MDS and conventional karyotype assessment is inadequate (e.g., <20 metaphases) or unresolved. Medicare covers up to four initial FISH probes (−7/del(7q), −5/del(5q), +8, del(20q)); additional reflex probes are allowed only if those four are negative or diagnosis remains uncertain. Generally, conventional karyotyping is sufficient and routine FISH beyond these conditions is not considered reasonable and necessary.

"Cover FISH probes for patients with bone marrow examination suggestive of myelodysplastic syndrome (MDS) when conventional karyotype cytogenetic assessment is inadequate."

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