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CodeMap® LCD-L38966

 

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L38966
LCD for MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer (L38966)
See related Articles:
A54338-Billing and Coding: MolDX: Germline testing for use of PARP inhibitors
A58652-Billing and Coding: MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer
A59058-Response to Comments: MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer

Contractor Information

Contractor Name: Palmetto GBA - Full list of policies of this Medicare Contractor

Contractor Number: 10211

Contractor Type: MAC A

LCD Information

LCD ID Number: L38966 Status: A-Approved

LCD Title: MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer

Geographic Jurisdiction: Georgia Other Jurisdictions

Original Determination Effective Date: 07/03/2022

Original Determination Ending Date:

Revision Effective Date: 04/18/2024

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 CFR §410.32(a) 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

National Coverage Determination (NCD) 90.2, which allows contractors to cover next generation sequencing tests as a diagnostic laboratory test for patients with cancer in specific circumstances


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12/10/2024 06:29:07 18.97.14.84

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