Billing and Coding: MolDX: Biomarkers in Cardiovascular Risk Assessment (A57055) - R6 - Effective October 1, 2025

Date Posted: August 28, 2025

This Billing and Coding Article has been revised under contract numbers: 02102 (AK), 02202 (ID), 02302 (OR), 02402 (WA), 03102 (AZ), 03202 (MT), 03302 (ND), 03402 (SD), 03502 (UT), and 03602 (WY).

Effective Date: October 1, 2025

Summary of Changes:

Under ICD-10 Codes that Support Medical Necessity Group 1: Codes deleted E78.01 and E88.1. Added E78.010, E78.011, and E78.019. This revision is due to the Annual ICD-10-CM Update and will become effective on 10/1/2025.

Under CMS National Coverage Policy revised the following regulation: CMS Internet-Only Manual, Pub. 100-04, Medicare Claims Processing Manual, Chapter 16, §50.5 Jurisdiction of Laboratory Claims, §60.1.1 Independent Laboratory Specimen Drawing, §60.2 Travel Allowance. This revision is effective 10/1/2025.

Updated Associated Documents to remove Billing and Coding: MolDX: ApoE Genotype.

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

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