Policy Revision(s) for MolDX Local Coverage Determinations and Associated Billing and Coding Articles - Effective February 5, 2026

Date Posted: February 5, 2026

The following Local Coverage Determinations (LCDs) and associated Billing and Coding Articles have been revised under contract numbers: 01111 (CA), 01211 (AS, GU, HI, NMI), 01311 (NV), and 01911 (CA, HI & Territories).

Medicare Coverage Database Number LCD Title and Revision Number
L38972 MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer - R2
L38814 MolDX: Minimal Residual Disease Testing for Cancer - R1
L35160 MolDX: Molecular Diagnostic Tests (MDT) - R18
L39001 MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing - R6
L39948 MolDX: Molecular Testing for Identification and Management of Hereditary Transthyretin Amyloidosis - R1
L39682 MolDX: Molecular Testing for Risk Stratification of Thyroid Nodules - R2
L38119 MolDX: Next-Generation Sequencing for Solid Tumors - R3
L38123 MolDX: Next-Generation Sequencing Lab-Developed Tests for Myeloid Malignancies and Suspected Myeloid Malignancies - R3
L39923 MolDX: Non-Next Generation Sequencing Tests for the Diagnosis of BCR-ABL Negative Myeloproliferative Neoplasms - R3
L36335 MolDX: NRAS Genetic Testing - R8
L36941 MolDX: Oncotype DX® Breast Cancer for DCIS (Genomic Health™) - R6
L38643 MolDX: Phenotypic Biomarker Detection from Circulating Tumor Cells - R3
L38151 MolDX: Pigmented Lesion Assay - R3
L39230 MolDX: Plasma-Based Genomic Profiling in Solid Tumors - R2
L38327 MolDX: Predictive Classifiers for Early Stage Non-Small Cell Lung Cancer - R4
L38647 MolDX: Prognostic and Predictive Molecular Classifiers for Bladder Cancer - R3
L37299 MolDX: Prometheus® IBD sgi Diagnostic® Policy - R9
L38339 MolDX: Prostate Cancer Genomic Classifier Assay for Men with Localized Disease - R4
L38351 MolDX: Repeat Germline Testing - R3
Medicare Coverage Database Number Billing and Coding Article Title and Revision Number
A58679 Billing and Coding: MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer - R11
A58454 Billing and Coding: MolDX: Minimal Residual Disease Testing for Solid Tumor Cancers - R16
A58996 Billing and Coding: MolDX: Minimal Residual Disease Testing for Hematologic Cancers - R10
A57526 Billing and Coding: MolDX: Molecular Diagnostic Tests (MDT) - R27
A58720 Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing - R33
A59872 Billing and Coding: MolDX: Molecular Testing for Identification and Management of Hereditary Transthyretin Amyloidosis - R2
A59509 Billing and Coding: MolDX: Molecular Testing for Risk Stratification of Thyroid Nodules - R1
A57901 Billing and Coding: MolDX: Next-Generation Sequencing for Solid Tumors - R8
A57891 Billing and Coding: MolDX: Next-Generation Sequencing Lab-Developed Tests for Myeloid Malignancies and Suspected Myeloid Malignancies - R11
A59835 Billing and Coding: MolDX: Non-Next Generation Sequencing Tests for the Diagnosis of BCR-ABL Negative Myeloproliferative Neoplasms - R2
A57486 Billing and Coding: MolDX: NRAS Genetic Testing - R4
A57619 Billing and Coding: MolDX: Oncotype DX® Breast Cancer for DCIS (Genomic Health™) - R3
A58183 Billing and Coding: MolDX: Phenotypic Biomarker Detection from Circulating Tumor Cells - R6
A58052 Billing and Coding: MolDX: Pigmented Lesion Assay - R4
A58973 Billing and Coding: MolDX: Plasma-Based Genomic Profiling in Solid Tumors - R11
A57329 Billing and Coding: MolDX: Predictive Classifiers for Early Stage Non-Small Cell Lung Cancer - R6
A58181 Billing and Coding: MolDX: Prognostic and Predictive Molecular Classifiers for Bladder Cancer - R8
A57516 Billing and Coding: MolDX: Prometheus® IBD sgi Diagnostic® Policy - R5
A57372 Billing and Coding: MolDX: Prostate Cancer Genomic Classifier Assay for Men with Localized Disease - R5
A57331 Billing and Coding: MolDX: Repeat Germline Testing - R20

Effective Date: February 5, 2026

Summary of Changes:

CONTRACTOR INFORMATION:

Added: JF contractor information

This update is to consolidate JE and JF to have one unified document and policy number.

Visit the Noridian Molecular Diagnostic Services webpage to view the Active MolDX LCDs or access it via the CMS MCD.

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