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- CAP advocacy improves special stains coverage
Cigna Government Services, the Medicare Administrative Contractor (MAC) for Ohio and Kentucky, expands coverage for special histochemical stains and immunohistochemical stains.
Why it matters: The updates enhance testing options across subspecialties like breast, lung, and prostate pathology.
- The CAP and its members worked for several years to effect these changes. They are a direct response to the CAP’s formal reconsideration request initiated in December 2021.
What's next: The revised local coverage determination (LCD), effective June 7, 2025, expands coverage for Lynch Syndrome tumor screening and MMR/MSI testing, providing greater flexibility and clearer guidance for pathologists.
- The CAP anticipates Noridian will adopt the new revisions, aligning with other MACs in improving coverage.
Go deeper: CAP members should familiarize themselves with the new documentation requirements for the revised LCD. Learn more about the changes.