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CodeMap® 10/7/2011: Palmetto LCD for Molecular Diagnostic Tests

CodeMap® Compliance Briefing: 10/07/2011

Editor's Welcome:  Palmetto GBA, the Medicare Administrative Contractor (MAC) for California, Hawaii, Nevada, Guam and American Samoa, has published a draft Local Coverage Determination (LCD) that will affect a wide variety of laboratory developed tests (LDTs) and DNA based tests currently reported using nonspecific "stacks" of molecular diagnostic codes. This proposed policy could have far reaching effects if it is adopted by other Medicare contractors and/or commercial payers as a means of limiting coverage and setting payment levels for many proprietary tests, especially DNA based assays. Today, we will summarize Palmetto's proposed policy and how it will apply to various tests and providers. As always, please contact us via email if you have any questions or comments.


Gregory Root, Esq.

Palmetto LCD for Molecular Diagnostic Tests 

by: Dr. Charles B. Root

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