Medical Policy Updates

Medical Policy Update April 21, 2022

Medical Guidelines Reason for Update
Microsatellite Instability and Tumor Mutational Burden Testing AHS-M2178 New policy developed. BCBSNC will provide coverage for 1) tumor mutational (TMB) testing (Note 1) for solid tumors (Note 3) done on tissue or liquid biopsy (Note 2) is considered medically necessary for individuals being considered for Pembrolizumab (Keytruda) therapy and 2) microsatellite instability (MSI) testing (Note 3) by tissue or liquid biopsy (Note 2) for all solid tumors is considered medically necessary for individuals being considered for Pembrolizumab (Keytruda).