MolDX: Blood Product Molecular Antigen Typing

Medicare provides limited coverage for molecular blood product antigen phenotyping when used in pre-transfusion evaluations for patients expected to require long-term, frequent transfusions, when serologic testing is impeded by autoantibodies or other reactivity, when typing sera are unavailable, or to resolve serologic discrepancies. Laboratory-developed tests may be covered if demonstrated equivalent or superior in validity and clinical utility; single-gene tests are generally not covered except in rare, well-documented circumstances. Medical necessity must be documented in the medical record and tests classified as germline must comply with germline testing policies.

"Molecular phenotyping of blood product antigens is covered as part of pre-transfusion evaluation when the patient is anticipated to require long-term, frequent transfusions (RBCs, platelets, or leu..."