LCDActive
MolDX: Envisia, Veracyte, Idiopathic Pulmonary Fibrosis Diagnostic Test
L37919
Wisconsin Physicians Service Insurance Corporation (J05)
Effective: June 29, 2023
Updated: December 31, 2025
Policy Summary
Limited coverage is provided for the Envisia genomic classifier for patients with interstitial lung disease when idiopathic pulmonary fibrosis is suspected but HRCT is not definitive for UIP, and there is no known alternative cause of ILD. Testing is intended for bronchoscopy transbronchial biopsy samples to yield a categorical UIP versus non-UIP result to aid management and potentially avoid surgical lung biopsy, particularly in older patients or those with high biopsy risk.
Coverage Criteria Preview
Key requirements from the full policy
"Envisia is covered for patients with interstitial lung disease (ILD) who are suspected of having idiopathic pulmonary fibrosis (IPF) and do not have a definitive usual interstitial pneumonia (UIP) ..."
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