| LCD | Title |
Revision Effective Date |
| L38284 |
MolDX: Predictive Classifiers for Early Stage Non-small Cell Lung Cancer-CGS Administrators, LLC |
07/03/2025 |
| L38433 |
MolDX: Prostate Cancer Genomic Classifier Assay for Men with Localized Disease-Wisconsin Physicians Service Insurance Corporation |
07/03/2025 |
| L38443 |
MolDX: Predictive Classifiers for Early Stage Non-Small Cell Lung Cancer-Wisconsin Physicians Service Insurance Corporation |
07/03/2025 |
| L38684 |
MolDX: Prognostic and Predictive Molecular Classifiers for Bladder Cancer-Wisconsin Physicians Service Insurance Corporation |
07/03/2025 |
| L39042 |
MolDX: Molecular Biomarkers to Risk-Stratify Patients at Increased Risk for Prostate Cancer-Wisconsin Physicians Service Insurance Corporation |
07/03/2025 |
| L39044 |
MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing-Wisconsin Physicians Service Insurance Corporation |
07/03/2025 |
| L38582 |
MolDX: Molecular Testing for Solid Organ Allograft Rejection-CGS Administrators, LLC |
07/10/2025 |
| L38680 |
MolDx: Molecular Testing for Solid Organ Allograft Rejection-Wisconsin Physicians Service Insurance Corporation |
07/10/2025 |
| L33394 |
Drugs and Biologicals, Coverage of, for Label and Off-Label Uses-National Government Services, Inc. |
07/13/2025 |
| L35000 |
Molecular Pathology Procedures-National Government Services, Inc. |
07/13/2025 |
| L37606 |
Genomic Sequence Analysis Panels in the Treatment of Hematolymphoid Diseases-National Government Services, Inc. |
07/13/2025 |
| L34040 |
Polysomnography and Other Sleep Studies-Noridian Healthcare Solutions, LLC |
07/20/2025 |
| L36861 |
Polysomnography and Other Sleep Studies-Noridian Healthcare Solutions, LLC |
07/20/2025 |
| L38278 |
Non-Invasive Fractional Flow Reserve (FFR) for Ischemic Heart Disease-Palmetto GBA |
08/03/2025 |
| L35041 |
Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers-Novitas Solutions, Inc. |
01/01/2026 |
| L36377 |
Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers-First Coast Service Options, Inc. |
01/01/2026 |
| L39865 |
Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers-Wisconsin Physicians Service Insurance Corporation |
01/01/2026 |
