CodeMap® LCD-L35160

Contractor Information

Contractor Name: Noridian Healthcare Solutions, LLC - Full list of policies of this Medicare Contractor

Contractor Number: 01211
Contractor Type: MAC A

LCD Information

LCD ID Number: L35160 Status: A-Approved
LCD Title: MolDX: Molecular Diagnostic Tests (MDT)
Geographic Jurisdiction: American Samoa, Guam, Hawaii, Northern Mariana Islands 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, §(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.

03/15/2025 06:48:57 18.97.14.83

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