Medicare Administrative Contractor CGS Aligns Coverage for Melanoma Risk Stratification Tests

Medicare Administrative Contractor CGS Administrators has aligned its coverage for melanoma risk stratification tests in patients with cutaneous melanoma, including Castle Biosciences’ DecisionDx-Melanoma test.

The revised local coverage determination goes into effect Dec. 21 and aligns coverage for molecular diagnostic tests used to aid in risk stratification of melanoma patients with Palmetto GBA’s previously announced expanded LCD.

The LCD is a general policy covering the tests when patients have a history of melanoma and either stage T1b and above or T1a with documented concern about adequacy of microstaging. Patients cannot have metastatic disease, must also be undergoing workups or being evaluated for treatment, and must have presumed risk greater than 5 percent for a positive sentinel lymph node biopsy based on clinical or histological information. The patient also must have a disease stage, grade, and Breslow thickness within the intended use of the test. 

Source: https://www.genomeweb.com/reimbursement-news/medicare-administrative-contractor-cgs-aligns-coverage-melanoma-risk