MolDx Covered Tests - JF Part A
MolDx Covered Tests
MolDX reviews test registration applications and technical assessments (TA) to confirm that each test meets Medicare reasonable and necessary criteria. Covered tests reviewed through the TA process are identified in the Molecular Diagnostic Test policy found in the LCD section. Coding and Billing guidelines are available to facilitate reimbursement.
All LCDS are the same for each state within a Jurisdiction and are accessible from the table below.
Access LCD or Article: Select the LCD or Article number in the table below to view the policy or article on the Medicare Coverage Database (MCD).
Print the LCD or Article: Select the LCD or Article number in the table below to view the policy or article on the Medicare Coverage Database (MCD).
- Click on the blue download arrow on the right side of page when LCD or Article appears.
- Click the print when PDF opens.
Not all Local Coverage Determinations (LCDs) have an associated article(s). Not all articles are associated to an LCD.
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| LCD Number | MolDX LCD Title | Associated Articles | CPT/HCPCS Codes Referenced |
|---|---|---|---|
| L37122 | MolDX: 4Kscore Assay |
|
81539 |
| L36884 | MolDX: APC and MUTYH Gene Testing |
|
81201, 81202, 81203, 81401, 81403, 81406, 81435, 81436, 81479 |
| L37062 | MolDX: BDX-XL2 |
|
0080U |
| L36362 | MolDX: Biomarkers in Cardiovascular Risk Assessment | 81401, 82172, 82610, 83090, 83695, 83698, 83700, 83701, 83704, 83719, 83721, 86141 | |
| L36163 | MolDX: BRCA1 and BRCA2 Genetic Testing | 81162, 81163, 81164, 81165, 81166, 81167, 81212, 81215, 81216, 81217, 81432, 81433, 81445, 81455, 81479, 0102U, 0103U, 0129U, 0131U, 0132U, 0133U, 0134U, 0135U, 0136U, 0137U, 0138U, 0157U, 0158U, 0159U, 0160U, 0161U, 0162U | |
| L36386 | MolDX: Breast Cancer Assay: Prosigna |
|
81520 |
| L37824 | MolDX: Breast Cancer IndexTM (BCI) Gene Expression Test |
|
81518 |
| L36329 | MolDX: ConfirmMDx Epigenetic Molecular Assay |
|
81551 |
| L37675 | MolDX: Corus® CAD Assay |
|
81493 |
| L37618 | MolDX: Cystatin C Measurement |
|
82610 |
| L37748 | MolDX: DecisionDx-Melanoma |
|
81599 |
| L37072 | MolDX: DecisionDx-UM (Uveal Melanoma) |
|
81552 |
| L37311 | MolDX: EndoPredict® Breast Cancer Gene Expression Test |
|
81599 |
| L37891 | MolDX: Envisia, Veracyte, Idiopathic Pulmonary Fibrosis Diagnostic Test |
|
81479 |
| L36186 | MolDX: Genetic Testing for BCR-ABL Negative Myeloproliferative Disease | 81206, 81207, 81208, 81219, 81270, 81402, 81403, 81445, 81450, 81455, 81479, 0040U | |
| L36374 | MolDX: Genetic Testing for Lynch Syndrome | 81162, 81163, 81164, 81165, 81166, 81167, 81212, 81215, 81216, 81217, 81432, 81433, 81445, 81455, 81479, 0102U, 0103U, 0129U, 0131U, 0132U, 0133U, 0134U, 0135U, 0136U, 0137U, 0138U, 0157U, 0158U, 0159U, 0160U, 0161U, 0162U | |
| L36368 | MolDX: Genomic Health™ Oncotype DX® Prostate Cancer Assay |
|
0047U |
| L36149 | MolDX: HLA-B*15:02 Genetic Testing |
|
81381 |
| L36544 | MolDX: HLA-DQB1*06:02 Testing for Narcolepsy |
|
81383 |
| L37899 | MolDX: Inivata, InVisionFirst, Liquid Biopsy for Patients with Lung Cancer |
|
81479 |
| L37622 | MolDX: MDS FISH |
|
88271, 88273, 88274, 88275, 88291 |
| L36192 | MolDX: MGMT Promoter Methylation Analysis |
|
81287 |
| L36256 | MolDX: Molecular Diagnostic Tests (MDT) |
|
0001U, 0003U, 0004M, 0005U, 0006M, 0007M, 0008M, 0009U, 0011M, 0012M, 0012U, 0013M, 0013U, 0014U, 0016U, 0017M, 0017U, 0018U, 0019U, 0021U, 0022U, 0023U, 0024U, 0026U, 0027U, 0029U, 0030U, 0031U, 0032U, 0033U, 0034U, 0039U, 0040U, 0045U, 0046U, 0047U, 0048U, 0049U, 0050U, 0053U, 0054U, 0055U, 0056U, 0057U, 0058U, 0059U, 0060U, 0070U, 0071U, 0072U, 0073U, 0074U, 0075U, 0076U, 0078U, 0079U, 0080U, 0083U, 0084U, 0087U, 0088U, 0089U, 0090U, 0091U, 0092U, 0094U, 0101U, 0102U, 0103U, 0104U, 0107U, 0108U, 0111U, 0113U, 0114U, 0118U, 0120U, 0129U, 0130U, 0131U, 0132U, 0134U, 0135U, 0136U, 0137U, 0138U, 0153U, 0154U, 0155U, 0156U, 0157U, 0158U, 0159U, 0160U, 0161U, 0162U, 0242U, 0244U, 0245U, 0246U, 81105, 81106, 81107, 81107, 81108, 81109, 81110, 81111, 81112, 81120, 81161, 81162, 81163, 81164, 81166, 81167, 81170, 81171, 81172, 81173, 81174, 81175, 81176, 81177, 81178, 81179, 81180, 81181, 81182, 81183, 81184, 81185, 81186, 81187, 81188, 81189, 81190, 81200, 81201, 81202, 81203, 81204, 81205, 81206, 81207, 81208, 81209, 81210, 81212, 81215, 81216, 81217, 81218, 81219, 81220, 81221, 81222, 81223, 81224, 81225, 81226, 81227, 81228, 81229, 81230, 81231, 81232, 81233, 81234, 81235, 81235, 81236, 81237, 81238, 81239, 81240, 81241, 81242, 81243, 81244, 81245, 81246, 81247, 81248, 81249, 81250, 81251, 81252, 81253, 81254, 81255, 81256, 81257, 81258, 81259, 81260, 81261, 81262, 81263, 81264, 81265, 81266, 81267, 81268, 81269, 81270, 81271, 81272, 81273, 81274, 81275, 81276, 81277, 81283, 81284, 81285, 81286, 81287, 81288, 81289, 81290, 81291, 81292, 81293, 81294, 81295, 81296, 81297, 81298, 81299, 81300, 81301, 81302, 81303, 81304, 81305, 81306, 81307, 81308, 81309, 81310, 81311, 81312, 81314, 81315, 81316, 81317, 81318, 81319, 81320, 81321, 81322, 81323, 81324, 81325, 81326, 81327, 81328, 81329, 81330, 81331, 81332, 81333, 81334, 81335, 81336, 81337, 81340, 81341, 81342, 81343, 81344, 81345, 81346, 81350, 81355, 81361, 81362, 81363, 81364, 81400, 81401, 81402, 81403, 81404, 81405, 81406, 81407, 81407, 81410, 81411, 81412, 81413, 81414, 81415, 81416, 81417, 81420, 81422, 81425, 81426, 81427, 81430, 81431, 81432, 81433, 81435, 81435, 81436, 81437, 81438, 81439, 81440, 81442, 81443, 81445, 81448, 81450, 81455, 81460, 81465, 81470, 81471, 81479, 81490, 81493, 81500, 81503, 81504, 81506, 81507, 81508, 81509, 81510, 81511, 81512, 81518, 81519, 81520, 81521, 81522, 81525, 81528, 81535, 81536, 81538, 81539, 81540, 81541, 81542, 81545, 81551, 81552, 81595, 81599, 84999, 85999, 86152, 86153, 86849, 87999, 88121, 91165 |
| L36171 |
|
0001U | |
| L37315 | MolDX: Multiplex Nucleic Acid Amplified Tests for Respiratory Viral Panels |
|
87631, 87632, 87633, 0098U, 0099U, 0100U, 0115U |
| L37881 | MolDX: myPath Melanoma Assay |
|
81479, 0090U |
| L36339 | MolDX: NRAS Genetic Testing |
|
81311, 81479 |
| L37744 | MolDX: Oncotype DX AR-V7 Nucleus Detect for Men with Metastatic Castrate Resistant Prostate Cancer (MCRPC) |
|
81479 |
| L36947 | MolDX: Oncotype DX® Breast Cancer for DCIS (Genomic Health™) |
|
0045U |
| L37321 | MolDX: Oncotype DX® Genomic Prostate Score for Men with Favorable Intermediate Risk Prostate Cancer |
|
0047U |
| L36891 | MolDX: Percepta© Bronchial Genomic Classifier |
|
81479 |
| L38337 | MolDX: Pharmacogenomics Testing |
|
81220, 81225, 81226, 81227, 81231, 81232, 81283, 81306, 81335, 81350, 81355, 81371, 81373, 81379, 81406, 0030U, 0070U, 0071U, 0072U, 0073U, 0074U, 0075U, 0076U |
| L38329 | MolDX: Predictive Classifiers for Early Stage Non-Small Cell Lung Cancer |
|
81479 |
| L36350 | MolDX: Prolaris™ Prostate Cancer Genomic Assay |
|
81541 |
| L37082 | MolDX: Prolaris™ Prostate Cancer Genomic Assay for Men with Favorable Intermediate Risk Disease |
|
81479 |
| L36706 | MolDX: ProMark Risk Score |
|
81479 |
| L38137 | MolDX: TruGraf Blood Gene Expression Test |
|
81479 |
Non LCD Related Articles
| Article Number | MolDX Title | CPT/HCPCS Codes Referenced |
|---|---|---|
| A56323 | Billing and Coding: MolDX: Clonoseq® Assay for Assessment of Minimal Residual Disease (MRD) in Patients with Specific Lymphoid Malignancies | 81479 |
| A56013 | Billing and Coding: MolDX: FDA Approved CLL Companion Diagnostic Test | 82271, 82275, 88291, 88374, 88377 |
| A55278 | Billing and Coding: MolDX: L1CAM Gene Sequencing | 81407 |
| A55591 | Billing and Coding: MolDX: Mitochondrial Nuclear Gene Tests | 81479 |
| A55615 | Billing and Coding: MolDX: NSD1 Gene Tests | 81403, 81405, 81406, 81479 |
| A55614 | Billing and Coding: MolDX: RPS19 Gene Tests | 81403, 81405, 81479 |
| A56518 | Billing and Coding: MolDX: Targeted and Comprehensive Genomic Profile Next-Generation Sequencing Testing in Cancer | 81445, 81450, 81479 |
| A58121 | Billing and Coding: MolDX: Testing of Multiple Genes | 81120, 81121, 81161, 81162, 81163, 81164, 81165, 81166, 81167, 81170, 81171, 81172, 81173, 81174, 81175, 81176, 81177, 81178, 81179, 81180, 81181, 81182, 81183, 81184, 81185, 81186, 81187, 81188, 81189, 81190, 81200, 81201, 81202, 81203, 81204. 81205, 81206, 81207, 81208, 81209, 81210, 81212, 81215, 81216, 81217, 81218, 81219, 81220, 81221, 81222, 81223, 81224, 81225, 81226, 81227, 81228, 81229, 81230, 81231, 81232, 81233, 81234, 81235, 81236, 81237, 81238, 81239, 81240, 81241, 81242, 81242, 81243, 81244, 81245, 81246, 81247, 81248, 81249, 81250, 81251, 81252, 81253, 81254, 81255, 81256, 81257, 81258, 81259, 81260, 81261, 81262, 81263, 81264, 81265, 81266, 81267, 81268, 81269, 81270, 81271, 81272, 81273, 81274, 81275, 81276, 81283, 81284, 81285, 81286, 81287, 81288, 81289, 81290, 81291, 81292, 81293, 81294, 81295, 81296, 81297, 81298, 81299, 81300, 81301, 81302, 81303, 81304, 81305, 81306, 81307, 81308, 81309, 81310, 81311, 81312, 81313, 81314, 81315, 81316, 81317, 81318, 81319, 81320, 81321, 81322, 81323, 81324, 81325, 81326, 81327, 81328, 81329, 81330, 81331, 81332, 81333, 81334, 81335, 81336, 81337, 81340, 81341, 81342, 81343, 81344, 813445, 81346, 81350, 81355, 81361, 81362, 81363, 81364, 81370, 81371, 81372, 81373, 81374, 81375, 81376, 81377, 81378, 81379, 81380, 81381, 81382, 81400, 81401, 81402, 81403, 81404, 81405, 81406, 81407, 81408, 81410, 81411, 81412, 81413, 81414, 81430, 81431, 81432, 81433, 81434, 81435, 81436, 81437, 81438, 81439, 81440, 81442, 81443, 81445, 81448, 81450 |
| A55275 | MolDX: Know Error Update | 84999 |
| A56104 | MolDX: Microsatellite Instability-High (MSI-H) and Mismatch Repair Deficient (dMMR) Biomarker Billing and Coding Guidelines for Patients with Unresectable or Metastatic Solid Tumors | 81301, 81479, 88341, 88342 |
| A55293 | MolDX: myPap Billing and Coding Guidelines | 84999 |
| A55598 | MolDX: OncoCee Billing and Coding Guidelines | 86152, 86153 |
Last Updated Tue, 21 Sep 2021 14:39:08 +0000