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Excellus BlueCross BlueShieldCommercial · Billing Codes · Lab Tests (pathology) · Hematology, Oncology, PathologyMedium impact

Measurable Residual Disease (MRD) Assessment Testing 2.02.54

Effective date
Aug 20, 2026
Identified
Jun 20, 2026

Summary

Excellus policy 2.02.54 considers the ClonoSEQ Assay medically appropriate for measurable residual disease assessment only for acute lymphoblastic leukemia, chronic lymphocytic leukemia and multiple myeloma, the FDA approved indications. Flow cytometry is considered medically necessary to detect MRD in patients with leukemia, lymphoma or multiple myeloma, and MRD assessment is considered investigational for all other indications when using tests including Signatera, MyMRD, Guardant Reveal, Northstar Response, Invitae PCM MRD Monitoring, PCM Tissue Profiling and MRD Monitoring, HPV-SEQ and UroAmp MRD. The 08/20/26 annual review removed codes 0450U and 0451U and states that policy intent is unchanged.

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What to do

Action · 5 steps
01Already effective August 20, 2026: Before billing ClonoSEQ for MRD assessment, confirm the indication is acute lymphoblastic leukemia, chronic lymphocytic leukemia or multiple myeloma.
02Before billing flow cytometry for MRD, confirm the patient has leukemia, lymphoma or multiple myeloma.
03MRD testing for other indications, including the listed Signatera, MyMRD, Guardant Reveal, Northstar Response, Invitae PCM, HPV-SEQ and UroAmp MRD tests, is considered investigational.
04MRD testing may be performed by flow cytometry, next-generation sequencing or PCR, but testing for MRD by more than one laboratory method concurrently is not medically appropriate because it is duplicative.
05Genetic testing is appropriate only when performed by a CLIA-certified laboratory in a setting with qualified pre- and post-test counseling, and coverage applies only to members with a valid contract.

Codes mentioned

814798159986356881828818488185881878818888189

Original notice

Measurable Residual Disease (MRD) Assessment Testing 2.02.54
excellusbcbs.com · Always check the source before changing claims.
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Related policy hubs

Excellus BlueCross BlueShield policiesHematologyOncologyPathologyCode 81479Code 81599Code 86356Code 88182Code 88184Code 88185Code 88187Code 88188Code 88189

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