Article Detail - JE Part A
Policy Revision(s) for MolDX Local Coverage Determinations and Associated Billing and Coding Articles - Effective January 22, 2026
Date Posted: January 22, 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 |
|---|---|
| L36358 | MolDX: Biomarkers in Cardiovascular Risk Assessment - R11 |
| L38331 | MolDX: Blood Product Molecular Antigen Typing - R6 |
| L36380 | MolDX: Breast Cancer Assay: Prosigna® - R6 |
| L37822 | MolDX: Breast Cancer Index® (BCI) Gene Expression Test - R6 |
| L37070 | MolDX: DecisionDx-UM (Uveal Melanoma) - R7 |
| L37295 | MolDX: EndoPredict® Breast Cancer Gene Expression Test - R7 |
| L37887 | MolDX: Envisia™, Veracyte™, Idiopathic Pulmonary Fibrosis Diagnostic Test - R7 |
| L39686 | MolDX: Gene Expression Profile Tests for Decision-Making in Castration Resistant and Metastatic Prostate Cancers - R1 |
| L39944 | MolDX: Genetic Testing for Heritable Thoracic Aortic Disease - R1 |
| L36155 | MolDX: Genetic Testing for Hypercoagulability / Thrombophilia (Factor V Leiden, Factor II Prothrombin, and MTHFR) - R6 |
| L36551 | MolDX: HLA-DQB1*06:02 Testing for Narcolepsy - R6 |
| L37897 | MolDX: Inivata™, InvisionFirst®, Liquid Biopsy for Patients with Lung Cancer - R5 |
| L37750 | MolDX: Melanoma Risk Stratification Molecular Testing - R9 |
| L36188 | MolDX: MGMT Promoter Methylation Analysis - R7 |
| L39373 | MolDX: Molecular Assays for the Diagnosis of Cutaneous Melanoma - R2 |
| L39589 | MolDX: Molecular Biomarker Testing for Risk Stratification of Cutaneous Squamous Cell Carcinoma - R1 |
| L39467 | MolDX: Molecular Biomarker Testing to Guide Targeted Therapy Selection in Rheumatoid Arthritis - R3 |
| L39678 | MolDX: Molecular Biomarkers for Risk Stratification of Indeterminate Pulmonary Nodules Following Bronchoscopy - R1 |
| L39005 | MolDX: Molecular Biomarkers to Risk-Stratify Patients at Increased Risk for Prostate Cancer - R3 |
| L39262 | MolDX: Molecular Testing for Detection of Upper Gastrointestinal Metaplasia, Dysplasia, and Neoplasia - R2 |
| Medicare Coverage Database Number | Billing and Coding Article Title and Revision Number |
|---|---|
| A57037 | Billing and Coding: MolDX: Biomarkers in Cardiovascular Risk Assessment - R8 |
| A57124 | Billing and Coding: MolDX: Blood Product Molecular Antigen Typing - R6 |
| A57363 | Billing and Coding: MolDX: Breast Cancer Assay: Prosigna® - R4 |
| A57773 | Billing and Coding: MolDX: Breast Cancer Index® (BCI) Gene Expression Test - R4 |
| A57621 | Billing and Coding: MolDX: DecisionDx-UM (Uveal Melanoma) - R5 |
| A57607 | Billing and Coding: MolDX: EndoPredict® Breast Cancer Gene Expression Test - R5 |
| A57419 | Billing and Coding: MolDX: Envisia™, Veracyte™, Idiopathic Pulmonary Fibrosis Diagnostic Test - R6 |
| A59513 | Billing and Coding: MolDX: Gene Expression Profile Tests for Decision-Making in Castration Resistant and Metastatic Prostate Cancers - R1 |
| A59868 | Billing and Coding: MolDX: Genetic Testing for Heritable Thoracic Aortic Disease - R2 |
| A57423 | Billing and Coding: MolDX: Genetic Testing for Hypercoagulability / Thrombophilia (Factor V Leiden, Factor II Prothrombin, and MTHFR) - R6 |
| A57441 | Billing and Coding: MolDX: HLA-DQB1*06:02 Testing for Narcolepsy - R3 |
| A57664 | Billing and Coding: MolDX: Inivata™, InvisionFirst®, Liquid Biopsy for Patients with Lung Cancer - R4 |
| A57268 | Billing and Coding: MolDX: Melanoma Risk Stratification Molecular Testing - R5 |
| A57432 | Billing and Coding: MolDX: MGMT Promoter Methylation Analysis |
| A59179 | Billing and Coding: MolDX: Molecular Assays for the Diagnosis of Cutaneous Melanoma - R4 |
| A59386 | Billing and Coding: MolDX: Molecular Biomarker Testing for Risk Stratification of Cutaneous Squamous Cell Carcinoma - R1 |
| A59521 | Billing and Coding: MolDX: Molecular Biomarker Testing to Guide Targeted Therapy Selection in Rheumatoid Arthritis - R4 |
| A59505 | Billing and Coding: MolDX: Molecular Biomarkers for Risk Stratification of Indeterminate Pulmonary Nodules Following Bronchoscopy - R1 |
| A58718 | Billing and Coding: MolDX: Molecular Biomarkers to Risk-Stratify Patients at Increased Risk for Prostate Cancer - R6 |
| A59032 | Billing and Coding: MolDX: Molecular Testing for Detection of Upper Gastrointestinal Metaplasia, Dysplasia, and Neoplasia - R2 |
Effective Date: January 22, 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.
Last Updated Jan 22 , 2026
