MolDX: Molecular Biomarkers for Risk Stratification of Indeterminate Pulmonary Nodules Following Bronchoscopy

Coverage is limited to molecular tests that aid diagnosis or exclusion of lung cancer in patients with an indeterminate pulmonary nodule after a non-diagnostic bronchoscopy, provided the test is intended for the patient population, will meaningfully inform management per national guidelines, and alternative diagnostic procedures cannot or will not be performed first. Tests must demonstrate analytical and clinical validity and utility (peer‑reviewed evidence), complete the MolDX technical assessment, avoid duplicate testing, and exclude patients with prior lung cancer, current cancer, or who are at overall low or high risk where results would not change management; NGS for malignant-sample variant detection is out of scope.

"Beneficiary underwent bronchoscopy for an indeterminate pulmonary nodule (IPN)."

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