The Molecular Diagnostic Services (MolDX) Program was developed by Palmetto GBA in 2011 to identify and establish coverage and reimbursement for molecular diagnostic tests. This program performs the following functions.
- Facilitates detailed and unique identification through registration of molecular diagnostic tests to facilitate claims processing and to track utilization.
- Establishes clinical utility expectations.
- Completes technical assessments of published test data to determine clinical utility and coverage.
- Establishes reimbursement.
Palmetto GBA currently administers the MolDX Program and all its information.
|Active LCDs||View all active Local Coverage Determinations (LCDs)|
|Covered Tests||View MolDX LCDs and LCD Articles|
|Draft LCDs||View all draft LCDs|
|Excluded Tests||View MolDx tests excluded from coverage|
|Future LCDs||View all future LCDs|
- Determinations regarding coverage
- Coordination with McKesson to establish a unique identification numbers
- Coordination/communication with Noridian on all claims processing guidelines
- Implement MolDX guidelines in cooperation with MolDX contractor
- Process claims using MolDX guidelines
- Conduct Appeals/Reopenings for claims processing for Noridian providers
Providers in Noridian's Jurisdictions
- Continue to send new test documentation in regards to coverage consideration to MolDX contractor
- Submit claims to Noridian after unique identifiers have been assigned
- Send policy/coverage questions to Palmetto at firstname.lastname@example.org
- Contact Noridian Provider Contact Center with claims processing questions
- Submit Reopening/Appeals requests to Noridian
Last Updated Aug 21, 2015