Medical Review - Experimental/Investigational

Genetic Breast Cancer Assay (i.e. Oncotype DX -21 gene assay)

DESCRIPTION
Oncotype DX is a 21-gene assay that can provide individualized assessment of risk of recurrence in 10 years in patients whose disease is newly diagnosed, node-negative, stage I or II, and estrogen receptor positive and treated with tamoxifen. Oncotype DX may provide information to help clinicians better target chemotherapy to the patients who will benefit from it.

POLICY
Oncotype DX testing is considered experimental/investigational because it continues to be in clinical trials.

HCPCS Code
S3854

Determined by the Medical Director on May 18, 2004. January 1, 2006, deleted CPT code 84999 and added HCPCS code S3854.

(Web updated 1/2006)

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