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Contractor Information

Contractor Name: Noridian Healthcare Solutions, LLC - Full list of policies of this Medicare Contractor Contractor Number: 03302 Contractor Type: MAC B

LCD Information

LCD ID Number: L38121 Status: R- Retired LCD Title: MolDX: Next-Generation Sequencing for Solid Tumors Geographic Jurisdiction: North Dakota Other Jurisdictions Original Determination Effective Date: 05/17/2020 Original Determination Ending Date: 02/05/2026 Revision Effective Date: 06/08/2023 Revision End Date: 02/05/2026 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 CFR §410.32 Diagnostic x-ray tests, diagnostic laboratory tests, and other diagnostic tests: Conditions CMS Internet-Only Manual, Pub. 100-02, Medicare Benefit Policy Manual, Chapter 15, §80 Requirements for Diagnostic X-Ray, Diagnostic Laboratory, and Other Diagnostic Tests, §80.1.1 Certification Changes CMS Internet-Only Manual, Pub 100-03, Medicare National Coverage Determinations Manual, Chapter 1, Part 2, §90.2 Next-Generation Sequencing (NGS) for Patients with Advanced Cancer Sorry, you need to login or register to view additional sections of this Medicare policy. *