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Molecular Markers in Fine Needle Aspirates of the Thyroid
Effective date
Not stated in the notice
Identified
Jun 20, 2026
Summary
For individuals with thyroid nodules without strong clinical or radiologic findings suggestive of malignancy, in whom surgical decision making would be affected by test results, the Afirma Genomic Sequencing Classifier or ThyroSeq may be considered medically necessary on fine needle aspirates with indeterminate cytology (Bethesda category III or IV). Gene expression classifiers, genetic variant analysis, and molecular marker testing that do not meet the policy criteria, including single-gene TERT testing, are considered investigational.
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What to do
Action · 6 steps
01Billing team: Claims for the Afirma Genomic Sequencing Classifier or ThyroSeq need documentation that the thyroid nodule has no strong clinical or radiologic findings suggestive of malignancy and that surgical decision making would be affected by the test result.
02Claims for ThyroSeq, ThyraMIR with ThyGenX, Afirma BRAF after the Afirma Genomic Sequencing Classifier, or Afirma MTC after the Afirma Genomic Sequencing Classifier need documentation that the test is used to rule in malignancy to guide surgical planning for initial resection rather than a 2-stage surgical biopsy followed by definitive surgery.
03Do not bill gene expression classifiers, genetic variant analysis, or molecular marker testing that do not meet these criteria, including single-gene TERT testing, because the policy considers them investigational.
04For individuals who do not have surgery based on gene expression classifier or molecular marker results, regular active surveillance is indicated.
05Genetic counseling is recommended for individuals at risk for inherited disorders who wish to undergo genetic testing.
06Claims for services not documented to be medically necessary are not paid.
Codes mentioned
8140481405814798154684999C73D44.0
Original notice
Molecular Markers in Fine Needle Aspirates of the Thyroid
bcbsms.com · Always check the source before changing claims.
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