Cxbladder Helps You Confidently Evaluate Patients with Microhematuria

Pacific Edge is pleased to confirm an important Medicare coverage development for Cxbladder Triage (0363U) and Cxbladder Triage Plus (0420U), a next generation Cxbladder test with added DNA markers to enhance risk stratification.

On May 14, 2026, the Centers for Medicare & Medicaid Services (CMS) released draft Local Coverage Determinations (LCDs) proposing Medicare coverage for urine-based biomarkers used in the evaluation of patients with microhematuria. The draft LCDs specifically identify Cxbladder Triage and Cxbladder Triage Plus as covered tests for appropriately selected intermediate-risk patients.

Coverage is expected to apply to Medicare Fee-for-Service patients who meet the following criteria:

• Clinical presentation of microhematuria (MH); AND
• All other potential causes have been ruled out; AND
• No current or prior diagnosis of urothelial or other urologic malignancy; AND
• Intermediate-risk status as defined by published guidelines; AND
• No cystoscopy within the previous 6 months; AND
• Appropriate counseling and intent to forgo cystoscopy based on test results; AND
• No testing with the same or similar test within the previous 6 months.

What Does This Mean for Ordering Providers?

To help ensure compliance with Medicare billing requirements, Pacific Edge will begin requiring an Advanced Beneficiary Notice (ABN) for Medicare Fee-for-Service patients who fall outside the anticipated coverage criteria.

This includes patients considered high risk, including many men aged 65 years and older.¹ Please note that no ABN is required for Medicare Fee-for-Service patients who fall within the low-risk or Intermediate-risk guideline criteria.

We're Here to Help

Our team remains committed to supporting you and your patients through the evolving landscape of bladder cancer evaluation. For questions regarding patient eligibility, ABN requirements, or ordering Cxbladder, please email us at [email protected], or call us at 855-292-5237.

An update regarding Cxbladder Triage Plus availability is scheduled shortly.

¹ Barocas DA, Lotan Y, Matulewicz RS, Raman JD, Westerman ME, Kirkby E, Pak L, Souter L. Updates to Microhematuria: AUA/SUFU Guideline (2025). J Urol. 0(0). doi: 10.1097/JU.0000000000004490.