MDS FISH (L37622) - R6 - Effective June 30, 2022

Date Posted: October 16, 2025

This Local Coverage Determination (LCD) has been revised under contractor numbers: 02102 (AK), 02202 (ID), 02302 (OR), 02402 (WA), 03102 (AZ), 03202 (MT), 03302 (ND), 03402 (SD), 03502 (UT), Effective Date: June 30, 2022

Summary of Changes:

Updated Summary of Evidence: Paragraph 6 to add the word "microscopic." Updated Paragraph 7 first sentence to include (aka FISH). Updated Paragraph 16 = symbol. Noridian has modified certain language in the (LCD) to mirror the language used presently by the MolDX team at Palmetto GBA as part of an annual review. Revision history dates and language may not exactly match the MolDX PGBA revision history. However, these revisions do not change coverage or guidance.

Visit the Noridian Active LCDs webpage to view the Active LCD or access it via the CMS MCD.

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