Billing and Coding: MolDX: Prometheus IBD sgi Diagnostic Policy (A57516) - R4 - Effective October 20, 2022

Date Posted: September 25, 2025

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: October 20, 2022

Summary of Changes:

Updated CMS National Coverage Policy Formatting, punctuation, and typographical errors were corrected.

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

Last Updated Sep 25 , 2025