CodeMap® 
150 North Wacker Drive
Suite 2360
Chicago, IL 60606
847-381-5465 Phone
847-381-4606 Fax
customerservice@codemap.com
      


User Information

Create New Account

Lost Password

Username:
Password:


Quick Links

LCDs and LCAs
by Contractor

PLA Codes

Laboratory Fee Schedule

2024
2023

Physician Fee Schedule

2024
2023

OPPS Fee Schedule

2024-October
2024-July

ASC Fee Schedule

2024-October
2024-July

APC Codes

2024-October
2024-July

DRG Codes

2024
2023

ASP Drug Pricing Files

2024-October
2024-July


CMS Transmittals




CodeMap® LCD-L35025

 

Printer Friendly Version

L35025
LCD for MolDX: Molecular Diagnostic Tests (MDT) (L35025)
See related Articles:
A53098-Billing and Coding: MolDX: Afirma™ Assay by Veracyte Update
A53101-Billing and Coding: MolDX: bioTheranostics Cancer TYPE ID® Update
A53104-Billing and Coding: MolDX: MammaPrint
A53105-Billing and Coding: MolDX: Oncotype DX® Breast Cancer Assay
A53106-MolDX: Oncotype DX® Colon Cancer Assay Update
A53108-Billing and Coding: MolDx: ResponseDX Tissue of Origin®
A53480-Billing and Coding: MolDX: HTTLPR Gene Testing
A53484-Billing and Coding: MolDX: BluePrint® Test
A53538-Billing and Coding: MolDX: SULT4A1 Genetic Testing
A53558-Billing and Coding: MolDX: PIK3CA Gene Tests
A53574-Billing and Coding: MolDX: MECP2 Genetic
A53576-Billing and Coding: MolDX: KIF6 Genotype
A53585-Billing and Coding: MolDX: NSD1 Gene Tests
A53587-Billing and Coding: MolDX: RPS19 Gene Tests
A53589-Billing and Coding: MolDX: TERC Gene Tests
A53591-Billing and Coding: MolDX: TP53 Gene Test
A53596-Billing and Coding: MolDX: IKBKAP Genetic Testing
A53598-Billing and Coding: MolDX: HEXA Gene Analysis
A53600-Billing and Coding: MolDX: BCKDHB Gene Test
A53602-Billing and Coding: MolDX: Aspartoacyclase 2 Deficiency(ASPA) Testing
A53619-Billing and Coding: MolDX: HAX1 Gene Sequencing
A53624-Billing and Coding: MolDX: SMPD1 Genetic Testing
A53628-Billing and Coding: MolDX: FANCC Genetic Testing
A53630-Billing and Coding: MolDX: MCOLN1 Genetic Testing
A53638-Billing and Coding: MolDX: Fragile X
A53652-Billing and Coding: MolDX: ApoE Genotype
A53657-Billing and Coding: MolDX: 9p21 Genotype Test
A53659-Billing and Coding: MolDX: L1CAM Gene Sequencing
A53664-Billing and Coding: MolDX: PAX6 Gene Sequencing
A53669-Billing and Coding: MolDX: Mitochondrial Nuclear Gene Tests
A53702-Billing and Coding: MolDX: SEPT9 Gene Test
A54018-Billing and Coding: MolDX: FDA-Approved BRAF Tests
A54021-Billing and Coding: MolDX: FDA-Approved EGFR Tests
A54035-Billing and Coding: MolDX: MMACHC Test
A54472-Billing and Coding: MolDX: FDA-Approved KRAS Tests
A54832-Billing and Coding: MolDX: Short Tandem Repeat (STR) Markers and Chimerism (CPT® codes 81265-81268)
A55695-Billing and Coding: MolDX: Abbott RealTime IDH1 and IDH2 testing for Acute Myeloid Leukemia (AML)
A56072-Billing and Coding: MolDX: Microsatellite Instability-High (MSI-H) and Mismatch Repair Deficient (dMMR) Biomarker for Patients with Unresectable or Metastatic Solid Tumors
A56853-Billing and Coding: MolDX: Molecular Diagnostic Tests (MDT)
A59636-Billing and Coding: MolDX: Proteomics Testing
A59678-MolDX: Defining panel services in MolDX

Contractor Information

Contractor Name: Palmetto GBA - Full list of policies of this Medicare Contractor

Contractor Number: 10211

Contractor Type: MAC A

LCD Information

LCD ID Number: L35025 Status: A-Approved

LCD Title: MolDX: Molecular Diagnostic Tests (MDT)

Geographic Jurisdiction: Georgia Other Jurisdictions

Original Determination Effective Date: 10/01/2015

Original Determination Ending Date:

Revision Effective Date: 05/04/2023

Revision End Date:

CMS National Coverage Policy:

Title XVIII of the Social Security Act, §1862(a)(1)(A), states that no Medicare payment shall be made for items or services that "are not reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of malformed body member."

Title XVIII of the Social Security Act, §1862(a)(1)(D), Investigational or Experimental.

45 CFR §162.1002 (a)(5), Medical data code sets

CMS Internet-Only Manual, Pub. 100-08, Medicare Program Integrity Manual, Chapter 13, §13.5.4 Reasonable and Necessary Provisions in LCDs


Sorry, you need to login or register to view additional sections of this Medicare policy.

--
*


All information on this web site is compiled directly from information obtained from the Center for Medicare and Medicaid Services (CMS) and from its Contractors.

CodeMap® has made every reasonable effort to ensure the accuracy of the information contained on this web site. However, the ultimate responsibility for correct coding and claims submission lies with the provider of services. CodeMap® makes no representation, warranty, or guarantee that this compilation of Medicare information is error-free or that the use of this information will result in Medicare coverage and subsequent payment of claims. Final coverage and payment of claims are subject to many factors exclusively controlled by CMS and its contractors.

No part of this web page or data displayed may be redistibuted or used without the express written consent of Wheaton Partners, LLC.

12/11/2024 12:19:32 18.97.14.89

CodeMap® is a Registered Trademark of Wheaton Partners, LLC.