MolDX: Molecular Testing for Detection of Upper Gastrointestinal Metaplasia, Dysplasia, and Neoplasia

This contractor does not cover molecular tests for detection of upper gastrointestinal metaplasia, dysplasia, and neoplasia unless strict criteria are met, including active management for GERD and/or NDBE, absence of prior dysplasia or esophageal carcinoma, at least three guideline-defined Barrett's risk factors, and use within the validated population. Coverage also requires demonstrated analytical and clinical validity with peer-reviewed evidence, documentation that results will guide management, and successful completion of a required Technical Assessment; testing frequency must follow established national or society guidelines.

"Beneficiary is being actively managed for chronic gastroesophageal reflux disease (GERD) and/or non-dysplastic Barrett's esophagus (NDBE)."

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