COVERAGE AND REIMBURSEMENT
COVERAGE AND REIMBURSEMENT
Please contact the Biodesix Support Hotline at 1.866.432.5930 with any questions you may have regarding coverage and payment.
For patients with Medicare:
- Biodesix Lung Reflex®: The genes in the GeneStrat® test and the VeriStrat® proteomic test are covered by Medicare and many private payers. No out of pocket expense for Medicare or Medicaid patients.
For patients with private insurance:
- Biodesix® will file the claim and any necessary appeal with the patient’s insurance company. VeriStrat and the genes tested in GeneStrat have positive medical policy with a large number of National and Regional Health Plans.
Biodesix Assist™ Financial Support Program:
- Biodesix is committed to making GeneStrat and VeriStrat available to all patients.
- The Biodesix Assist Financial Support Program is available to those who qualify to reduce or eliminate potential patient responsibility.
- Patients may apply to pre-qualify for financial assistance at any point, including before the test in informed.
Biodesix’s VeriStrat test has medical policy coverage for over 228 million lives*, including those at:
BCBS of Michigan
Capital Health Plan
eviCore National Lab Management Program Guidelines
Group Health Cooperative
Health Alliance Plan (HAP) of Michigan
Health Care Services Corporation (HCSC) including BCBS of Texas, Oklahoma, Illinois, Montana, and New Mexico
Health Net, Inc.
Highmark Inc., a BCBS affiliate
Horizon BCBS of New Jersey
Johns Hopkins Health Care
Priority Health Michigan
*As of 22nd March 2018
|ICD-10 Code||Code Description|
|C33||Malignant neoplasm of trachea|
|C34.00||Malignant neoplasm of unspecified main bronchus|
|C34.01||Malignant neoplasm of right main bronchus|
|C34.02||Malignant neoplasm of left main bronchus|
|C34.10||Malignant neoplasm of upper lobe, unspecified bronchus or lung|
|C34.11||Malignant neoplasm of upper lobe, right bronchus or lung|
|C34.12||Malignant neoplasm of upper lobe, left bronchus or lung|
|C34.2||Malignant neoplasm of middle lobe, bronchus or lung|
|C34.30||Malignant neoplasm of lower lobe, unspecified bronchus or lung|
|C34.31||Malignant neoplasm of lower lobe, right bronchus or lung|
|C34.32||Malignant neoplasm of lower lobe, left bronchus or lung|
|C34.80||Malignant neoplasm of overlapping sites of unspecified bronchus and lung|
|C34.81||Malignant neoplasm of overlapping sites of right bronchus and lung|
|C34.82||Malignant neoplasm of overlapping sites of left bronchus and lung|
|C34.90||Malignant neoplasm of unspecified part of unspecified bronchus or lung|
|C34.91||Malignant neoplasm of unspecified part of right bronchus or lung|
|C34.92||Malignant neoplasm of unspecified part of left bronchus or lung|
|C38.4||Malignant neoplasm of pleura|
|C45.0||Mesothelioma of pleura|
Additional information on the ICD-10 transition is available from the Center for Medicare and Medicaid Services (CMS) at https://www.cms.gov/Medicare/Coding/ICD10/ProviderResources.html
Medicare Local Coverage Determination (LCD) L35396 Biomarkers for Oncology. Novitas Solutions. Effective 10/1/2015.
ICD-10 Transition 2015-09-23-01-RE