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Contractor Information

Contractor Name: Noridian Healthcare Solutions, LLC - Full list of policies of this Medicare Contractor Contractor Number: 01311 Contractor Type: MAC A

LCD Information

LCD ID Number: L36886 Status: R- Retired LCD Title: MolDX: Percepta© Bronchial Genomic Classifier Geographic Jurisdiction: Nevada Other Jurisdictions Original Determination Effective Date: 05/15/2017 Original Determination Ending Date: 09/22/2024 Revision Effective Date: 12/01/2019 Revision End Date: 09/22/2024 CMS National Coverage Policy: Title XVIII of the Social Security Act (SSA), §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 a malformed body member.” Title XVIII of the Social Security Act, §1833(e), prohibits Medicare payment for any claim lacking the necessary documentation to process the claim. 42 Code of Federal Regulations (CFR) §410.32 Diagnostic x-ray tests, diagnostic laboratory tests, and other diagnostic tests: Conditions. CMS Internet Only Manuals, Publication 10004, Medicare Claims Processing Manual¨ Ch. 16, §50.5 Jurisdiction of Laboratory Claims, 60.12 Independent Laboratory Specimen Drawing, 60.2. Travel Allowance. Sorry, you need to login or register to view additional sections of this Medicare policy. *