MolDX: Pigmented Lesion Assay
L38111
Coverage is limited to use of the DermTech Pigmented Lesion Assay for primary melanocytic skin lesions (5–19 mm) with ≥1 clinical or historical feature suggestive of melanoma when a clinician trained in skin-cancer diagnosis is considering biopsy. The test is for intact, non-ulcerated/non-bleeding lesions that have not been previously biopsied or scarred and are not located on palms, soles, nails, mucous membranes, or untrimable hair-covered areas; positive PLA (LINC00518 and/or PRAME) supports biopsy while negative PLA should not alone rule out biopsy. Orders must be by a physician or qualified provider with melanoma expertise and the medical record must document the clinical features, lesion size/location, skin integrity, prior biopsy/scar status, and the PLA result.
"PLA is covered to help rule out primary cutaneous melanoma and guide biopsy decisions for primary melanocytic skin lesions when there is ≥1 clinical or historical characteristic suggestive of melan..."