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

This contractor currently considers molecular diagnostic tests for upper gastrointestinal metaplasia, dysplasia, and neoplasia non-covered unless they meet multiple coverage criteria, including active management for GERD or non-dysplastic Barrett's esophagus, at least three guideline-defined Barrett's risk factors, no prior dysplasia or esophageal carcinoma, use within the validated population, demonstrated analytical and clinical validity with peer-reviewed evidence, and successful completion of a Technical Assessment. Tests must be used to inform management decisions and administered no more frequently than recommended by 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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