Date Posted: May 14, 2026

This Billing and Coding Article has been revised under contract numbers: 01112 (NCA), 01182 (SCA), 01212 (AS, GU, HI, and NMI), and 01312 (NV).

Effective Date: May 14, 2026

Summary of Changes:

Under Article Text revised 2nd sentence to remove "81170" and replace with "code". Added "Specific tests that have been evaluated for compliance with coverage criteria set in policy (and are thus covered or not covered) can be found in the DEX® registry". Under CPT/HCPCS Codes Group 2: Codes added 81479. Under ICD-10 Codes that Support Medical Necessity Group 1: Codes deleted C92.01, C92.11, C92.21, C92.31, C92.41, C92.51, C92.61, C92.A1, C92.Z1, C92.91, C93.01, C94.01, C94.21, and C94.41. These codes were included in error. Testing of patients clinically in remission is governed under a separate policy (MolDX: Minimal Residual Disease Testing for Cancer).

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