MolDX: EndoPredict® Breast Cancer Gene Expression Test and Billing and Coding: MolDX: EndoPredict® Breast Cancer Gene Expression Test - Effective July 11, 2021

This Local Coverage Determination (LCD) has completed the Open Public Meeting comment period and is now finalized under contractor numbers: 02101 (AK), 03101 (AZ), 02201 (ID), 03201 (MT), 03301 (ND), 02301 (OR), 03401 (SD), 03501 (UT), 02401 (WA), and 03601 (WY).

Medicare Coverage Database Number LCD Title
L37311 MolDX: EndoPredict® Breast Cancer Gene Expression Test

 

Medicare Coverage Database Number Billing and Coding Article
A57608 Billing and Coding: MolDX: EndoPredict® Breast Cancer Gene Expression Test

 

Effective Date: July 11, 2021
Summary: Limited coverage for the EndoPredict® breast cancer gene expression test (Myriad Genetic Laboratories Inc., Salt Lake City, UT) for the management of post-menopausal women diagnosed with early-stage (TNM stage T1-3, N0-1) estrogen-receptor (ER) positive, Her2-negative breast cancer, who are either lymph node-negative or who have 1-3 positive nodes, and for whom treatment with adjuvant endocrine therapy (e.g., tamoxifen or aromatase inhibitors) is being considered. The test is used by physicians in the management of these patients by identifying those who have sufficiently low risk of distant recurrence (DR) at 10 years and may safely forego chemotherapy.

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            Last Updated Wed, 26 May 2021 19:59:06 +0000