MolDX: Biomarker Testing for Risk Stratification in Metabolic Dysfunction-Associated Steatotic Liver Disease and Metabolic Dysfunction-Associated Steatohepatitis

Molecular or proteomic biomarker testing for assessment of liver fibrosis is covered for adults (age >=18) with suspected or diagnosed MASLD/MASH when a guideline-based primary non-molecular risk assessment indicates non-low risk (e.g., FIB-4 >=1.3), LSM is indeterminate or not performed, and the test result will directly inform pending management. Coverage requires published clinical validity with reproducibility (and independent algorithm validation if applicable), completion of a MolDX Technical Assessment, and adherence to frequency limits (no more than once per 12 months and not within 12 months after liver biopsy).

"Patient is an adult (age >= 18) with clinical suspicion or diagnosis of metabolic dysfunction-associated steatotic liver disease (MASLD) or metabolic dysfunction-associated steatohepatitis (MASH) b..."

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