LCD ID Number: L37195 Status: A-Approved
LCD Title: MolDX: Percepta® Bronchial Genomic Classifier
Geographic Jurisdiction: Michigan Other Jurisdictions
Original Determination Effective Date:
Original Determination Ending Date:
Revision Effective Date:
Revision End Date:
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.”
42 C.F.R. § 410.32 Diagnostic X-ray tests, diagnostic laboratory tests, and other diagnostic tests: Condition.
CMS Internet-Only Manual, Pub. 100-02, Medicare Benefit Policy Manual, Chapter 15, §80.0, Requirements for Diagnostic X-Ray, Diagnostic Laboratory, and other Diagnostic Tests, §80.1.1, Certification Changes.
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08/08/2022 01:36:59 188.8.131.52