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Clinical Appropriateness Guidelines Molecular Testing of ...

2021 AIM Specialty Health Clinical Appropriateness Guidelines Molecular Testing of Solid and Hematologic Tumors and Malignancies EFFECTIVE SEPTEMBER 6, 2021 PROPRIETARY Guidelines developed by, and used with permission from, Informed Medical Decisions, Inc. 2015-2021 Informed Medical Decisions, Inc. All Rights Reserved. 2 Table of Contents Scope .. 3 General Coverage Criteria .. 3 Conditions for which Testing may be medically necessary .. 4 The following tests are not medically necessary .. 6 Specific Coverage Criteria .. 6 Breast Cancer Gene Expression Classifiers .. 6 Cell-Free Testing .. 8 Minimal Residual Disease (MRD) Testing .. 9 Targeted Molecular Testing for NTRK Fusions.

Sep 06, 2021 · Susceptibility. For genetic testing used to guide chemotherapy treatment decisions, please refer to the Clinical Appropriateness Guidelines for Pharmacogenomic Testing and Genetic Testing for Thrombotic Disorders. In addition, testing required by a plan’s pharmaceutical policies may be adjudicated by that plan’s pharmaceutical guidelines.

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