MolDX: Pigmented Lesion Assay

The PLA (DermTech) is covered only as a diagnostic decision tool for primary melanocytic skin lesions 5–19 mm with intact skin and one or more ABCDE or other concerning features when a trained clinician is considering biopsy to rule out melanoma. Coverage excludes clinically obvious melanoma, prior‑biopsied or scarred lesions, lesions in inflammatory skin conditions or certain anatomic sites (palms, soles, nails, mucous membranes, untrimable hair-covered areas), and screening of patients without melanocytic lesions; documentation must include lesion site, a photograph, clinician competence, and a follow-up plan if PLA is negative. Tests are generally limited to one per lesion and one per patient per encounter, with limited exceptions (≈10% for a second test; >2 tests require appeal).

"PLA is indicated for evaluation of pigmented melanocytic skin lesions when a clinician trained in skin cancer diagnosis is considering whether to perform a biopsy to rule out melanoma."