Monday, November 7, 2022

MolDx Updates Multiple Technology Assessment Forms

MolDx divides its coverage rules among three sources, LCDs, billing articles attached to LCDs, and Technology Assessments, which are found on the MolDx website.

On November 2, 2022, MolDx updated a number of tech assessment forms.

  • NGS PF 004, TA for solid tumors.
  • NGS PF 005, TA for myeloid cancers.
  • NGS PF 006, TA for inherited cancer testing.
  • MRD PF 016, TA for minimal residual disease testing
For example, if you are testing for inherited risk of cancer in a breast cancer patient, see LCD L38972, its attached billing article, AND ALSO you must see NGS PF 006.   NGS PF 006 lists the genes that must be included in a panel when breast cancer is the reason for testing.   (For example, testing BRCA alone isn't allowed anymore).  

Note that TA spreadsheets often have multiple tabs.

Im hereditary cancer, PF006, if I tally correctly, for breast cancer only panels with at least 11 genes are covered (smaller panels are not covered, because the 11 genes are medically necessary and thus required).  These are PTEN, BRCA 1,2, STK11, TP53, PALB2, ATM, CHK2, NF1, RAD51C, RAD51D.