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LCD for MolDX: Molecular Diagnostic Tests (MDT) (L36807)
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Contractor Information

Contractor Name: Wisconsin Physicians Service Insurance Corporation - Full list of policies of this Medicare Contractor

Contractor Number: 08202

Contractor Type: MAC B

LCD Information

LCD ID Number: L36807 Status: A-Approved

LCD Title: MolDX: Molecular Diagnostic Tests (MDT)

Geographic Jurisdiction: Michigan Other Jurisdictions

Original Determination Effective Date: 02/16/2017

Original Determination Ending Date:

Revision Effective Date: 04/27/2023

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

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06/15/2024 12:03:22

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