Providers

Medical Policy Upcoming Updates

Notification Date: June 16, 2021

Below are the policies that are new or have been reviewed, along with the determination and summary of any changes.

Coverage Policies

Policy Title	Status	Effective Date	Determination	Summary of Change
Liquid Biopsy: Circulating Tumor Cells / Cell Free DNA	Re-Reviewed	06/16/2021 Enhanced Benefit	Covered for some indications; investigative and therefore not covered for all other indications	Liquid Biopsy is no longer investigative for solid tumors when the individual is unable to undergo standard tissue biopsy or there is insufficient tumor tissue available for testing. Liquid Biopsy is investigative for all other indications.
Magnetic Resonance Spectroscopy (MRS)	Re-Reviewed	06/16/2021 Enhanced Benefit	Covered for some indications; investigative and therefore not covered for all other indications	A new covered indication was added to the policy: No longer investigative for distinguishing brain neoplasm from non-neoplastic lesions. Remains investigative and not covered for all other indications.

The updated clinical policies and guidelines above will be available as of their effective date, as noted. View policies and guidelines.

To request paper copies of a policy, please leave a message at the Medica Provider Literature Request Line: 1-800-458-5512, option 1, then option 8, then ext. 2-2355.

Where information conflicts with applicable state and/or federal law, Medica follows such applicable federal and/or state law.