The CAP, the Association for Molecular Pathology (AMP), and other leading medical organizations successfully advocated for revisions to the Centers for Medicare & Medicaid Services (CMS) National Coverage Determination (NCD) for autologous stem cell transplantation (AuSCT) in Medicare beneficiaries with multiple myeloma (MM). This CMS NCD update represents a significant advancement for Medicare beneficiaries with MM.
Key revisions to the NCD include:
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Modernizing the disease-staging criteria for multiple myeloma AuSCT coverage by incorporating the International Staging System (ISS) and its revisions (R-ISS and R2-ISS) to replace older criteria referencing the Durie-Salmon staging system.
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Coverage at any stage using the ISS and its revisions, or at Stage II or III using the Durie-Salmon staging system.
These critical updates to the nearly 30-year-old NCD ensure that certain Medicare beneficiaries with MM will have direct access to modern clinical staging systems.
The revised policy was implemented on October 28.