Medical Director Articles

The term "article" is used to describe any bulletin article, web site article, educational handout or any other non-LCD document intended for public release that contains coverage/coding statements or medical review related billing or claims considerations.

Articles address local coverage, coding or medical review related billing and claims considerations, and may include any newly developed educational materials, coding instructions or clarification of existing medical review related billing or claims policy.

The article listing will continue to expand as additions are made.

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Articles Source Posted
2024 CPT/HCPCS Local Coverage Article (LCA) Updates jun 27, 2024
MolDX: Pigmented Lesion Assay (L38151) - R1 - Effective June 20, 2024 jun 20, 2024
MolDX: Melanoma Risk Stratification Molecular Testing (L37750) - R6 - Effective June 20, 2024 jun 20, 2024
Local Coverage Determinations (LCDs) Finalized - Effective July 28, 2024 jun 13, 2024
Billing and Coding Percutaneous Vertebral Augmentation (PVA) for Osteoporotic Vertebral Compression Fracture (VCF) (A56572) - R6 - Effective January 10, 2021 jun 13, 2024
Billing and Coding: Epidural Steroid Injections for Pain Management (A58993) - R3 -November 15, 2023 jun 11, 2024
Billing and Coding: Sacroiliac Joint Injections and Procedures (A59244) - R5 - Effective June 1, 2024 jun 11, 2024
Billing and Coding: Leadless Pacemakers (A59819) - Effective June 6, 2024 jun 07, 2024
Billing and Coding: MolDX: Billing and Coding: MolDx: ResponseDX Tissue of Origin (A54494) Retirement - Effective May 30, 2024 jun 06, 2024
Billing and Coding: MolDX: PAX6 Gene Sequencing (A55625) Retirement - Effective May 29, 2024 jun 06, 2024
Billing and Coding: MolDX: MMACHC Test (A55288) Retirement - Effective May 30, 2024 jun 06, 2024
Billing and Coding: MolDX: Mitochondrial Nuclear Gene Tests (A55290) Retirement - Effective May 29, 2024 jun 06, 2024
Billing and Coding: MolDX: CDH1 Genetic Testing (A55970) Retirement - Effective May 30, 2024 jun 06, 2024
Billing and Coding: MolDX: Proteomics Testing (A59641) - R4 - Effective May 30, 2024 may 30, 2024
Open Meeting Announcement Botulinum Toxin Injections, Micro Invasive Glaucoma Surgery (MIGS), Artificial Intelligence Enabled Quantitative Coronary Topography (AI-QCT)/Coronary Plaque Analysis (AI-CPA) - June 27, 2024 may 30, 2024
Billing and Coding: MolDX: SMPD1 Genetic Testing (A55627) Retirement - Effective May 21, 2024 may 30, 2024
Billing and Coding: MolDX: MCOLN1 Genetic Testing (A55283) Retirement - Effective May 23, 2024 may 30, 2024
Billing and Coding: MolDX: L1CAM Gene Sequencing (A55277) Retirement - Effective May 24, 2024 may 30, 2024
Billing and Coding: MolDX: Fragile X (A55241) Retirement - Effective May 23, 2024 may 30, 2024
Billing and Coding: MolDX: FANCC Genetic Testing (A55183) Retirement - Effective May 21, 2024 may 30, 2024
Billing and Coding: MolDX: FDA-Approved EGFR Tests (A54422) - R6 - Effective May 30, 2024 may 30, 2024
Billing and Coding: MolDX: 9p21 Genotype Test (A55092) Retirement - Effective May 24, 2024 may 30, 2024
Local Coverage Determinations (LCDs) Finalized - Effective July 7, 2024 may 23, 2024
MolDX: Clarification of Order Requirements for Laboratory and Molecular Diagnostic Services (A59743) - R1 - Effective May 23, 2024 may 23, 2024
Billing and Coding: MolDX: HAX1 Gene Sequencing (A55249) Retirement - Effective May 14, 2024 may 23, 2024
MolDX: Blood Product Molecular Antigen Typing (L38331) - R4 - Effective May 23, 2024 may 23, 2024
Billing and Coding: MolDX: Aspartoacyclase 2 Deficiency (ASPA) Testing (A55088) Retirement - Effective May 14, 2024 may 23, 2024
Billing and Coding: MolDX: HEXA Gene Analysis (A55255) Retirement - Effective May 8, 2024 may 16, 2024
Billing and Billing and Coding: MolDX: BCKDHB Gene Test (A55099) Retirement - Effective May 8, 2024 may 16, 2024
Billing and Coding: MolDX: IKBKAP Genetic Testing (A55612) Retirement - Effective May 7, 2024 may 16, 2024
Self-Administered Drug Exclusion List (A53032) - R35 - Effective June 23, 2024 may 09, 2024
Billing and Coding: MolDX: TP53 Gene Tests (A55484) Retirement - Effective May 1, 2024 may 09, 2024
Billing and Coding: MolDX: TERC Gene Tests (A55611) Retirement - Effective May 1, 2024 may 09, 2024
Billing and Coding: MolDX: RPS19 Gene Tests (A55610) Retirement - Effective April 30, 2024 may 09, 2024
Billing and Coding: MolDX: NSD1 Gene Tests (A55609) Retirement - Effective April 30, 2024 may 09, 2024
Skin Substitutes Grafts/Cellular Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers - Published for Review and Comments may 02, 2024
MolDX: Clarification of Order Requirements for Laboratory and Molecular Diagnostic services (A59743) - Effective May 2, 2024 may 02, 2024
Billing and Coding: MolDX: Prometheus® IBD sgi Diagnostic® Policy (A57516) - R3 - Effective October 20, 2022 may 02, 2024
Billing and Coding: MolDX: KIF6 Genotype (A55272) Retirement - Effective April 26, 2024 may 02, 2024
Billing and Coding: MolDX: MECP2 Genetic Testing (A55285) Retirement - Effective April 26, 2024 may 02, 2024
Billing and Coding: MolDX: CHD7 Gene Analysis (A55085) Retirement - Effective April 25, 2024 may 02, 2024
Billing and Coding: MolDX: STAT3 Gene Testing (A55480) Retirement - Effective April 24, 2024 may 02, 2024
Billing and Coding: MolDX: Know Error® (A55274) Retirement - Effective April 24, 2024 may 02, 2024
Billing and Coding: MolDX: PTCH1 Gene Testing (A55608) Retirement - Effective April 25, 2024 may 02, 2024
Multi-Jurisdictional CAC Meeting Announcement - MolDX: Biomarker Risk Stratification Testing in DCIS - July 15, 2024, 2 p.m. to 4 p.m. ET abr 30, 2024
Open Meeting Announcement Skin Substitutes Grafts/Cellular Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers - May 16, 2024 abr 25, 2024
Billing and Coding: MolDX: ATP7B Gene Tests (A55097) Retirement - Effective April 23, 2024 abr 25, 2024
Billing and Coding: MolDX: VEGFR2 Tests (A55468) Retirement - Effective April 23, 2024 abr 25, 2024
Billing and Coding: MolDX: myPap™ (A55292) Retirement - Effective April 19, 2024 abr 25, 2024
Billing and Coding: MolDX: GBA Genetic Testing (A55243) Retirement - Effective April 19, 2024 abr 25, 2024