Urinary Tumor Markers for Bladder Cancer
This reimbursement policy governs when urinary tumor marker laboratory tests for bladder cancer may be reimbursed by BCBSOK and explains excluded indications; it applies to providers submitting claims under the payer's products. Providers should also review specific plan documents for product-level applicability.
No material clinical or coverage changes in this revision.
Coverage Criteria for Urinary Tumor Marker Testing
Coverage Criteria
Reimbursement information and indications
ALL of the following
Reimbursable uses for urinary biomarkers
- As an adjunct in the diagnostic exclusion of bladder cancer for individuals who have an atypical or equivocal cytology
- As an adjunct in the monitoring of high-risk, non-muscle invasive bladder cancer
Reimbursable use for fluorescence immunocytology
- As an adjunct to cystoscopy or cytology in the monitoring of individuals with bladder cancer, the use of fluorescence immunocytology (ImmunoCyt/uCyt) may be reimbursable
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