Noridian Providing Limited Coverage for MDx Tests as Predictive Classifiers for NSCLC

Medicare Administrative Contractor Noridian Health Solutions recently issued a final local coverage determination aligning its coverage with Palmetto’s earlier decision to cover molecular diagnostic laboratory tests as predictive classifiers for non-small cell lung cancer.

Tests are considered reasonable and necessary if a patient has a non-squamous NSCLC with a tumor size of less than five centimeters and no positive lymph nodes. The patient must also be healthy enough to tolerate chemotherapy and adjuvant platinum-containing chemotherapy must be under consideration as treatment for the patient. The test must also be ordered by a clinician treating the patient for NSCLC to help decide whether to recommend adjuvant chemotherapy.

Source: https://www.genomeweb.com/reimbursement-news/noridian-providing-limited-coverage-mdx-tests-predictive-classifiers-nsclc