MolDX: EndoPredict Breast Cancer Gene Expression Test

Summary of Evidence Analysis of Evidence General Information Associated Information Sources of Information Bibliography Revision History Information Associated Documents Attachments Related Local Coverage Documents Related National Coverage Documents Public Versions Keywords Local Coverage Determination (LCD) MolDX: EndoPredict Breast Cancer Gene Expression Test L37264 Expand All | Collapse All  Email Document  Download  Add to basket Contractor Information Contractor Name Contract Type Contract Number Jurisdiction States LCD Information Document Information LCD ID L37264 LCD Title MolDX: EndoPredict Breast Cancer Gene Expression Test Proposed LCD in Comment Period N/A Source Proposed LCD DL37264 Original Effective Date For services performed on or after 10/02/2017 Revision Effective Date For services performed on or after 07/04/2021 Revision Ending Date N/A Retirement Date N/A Notice Period Start Date 05/20/2021 Notice Period End Date 07/03/2021 CPT codes, descriptions, and other data only are copyright 2025 American Medical Association. All Rights Reserved. Fee schedules, relative value units, conversion f

This Medicare contractor will provide limited coverage for the EndoPredict ® breast cancer gene expression test (Myriad Genetic Laboratories Inc., Salt Lake City, UT) for the management of post-menopausal women diagnosed with early-stage (TNM stage T1-3, N0-1) estrogen-receptor (ER) positive, Her2-negative breast cancer, who are either lymph node-negative or who have 1-3 positive nodes, and for whom treatment with adjuvant endocrine therapy (e.g., tamoxifen or aromatase inhibitors) is being considered. The test is used by physicians in the management of these patients by identifying those who have sufficiently low risk of distant recurrence (DR) at 10 years and may safely forego chemotherapy.