Technical Assessment (TA) Process

To determine coverage, a TA will be required for all new assays prior to submission of claims and for any procedure/service determined by the contractor to need additional scientific documentation. During the review period of the TA, claims submission for the service should be suspended in order to avoid denial. TA submissions may be completed through the McKesson Diagnostic Exchange™ at https://app.mckessondex.com. This online tool will prompt providers to enter the required information and provide a time-based tool to track the progress of the evaluation process. Based on the determination for each assay reviewed, Palmetto GBA will publish information to inform the provider community of the following: coverage, coverage with restrictions, non-coverage and coding guidelines.

MAC for Jurisdiction 11; comprised of North Carolina, South Carolina, Virginia and West Virginia; and MAC for Jurisdiction 1; comprised of California, Hawaii and Nevada.