Active MolDX LCDs - JF Part B
Active MolDX LCDs
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.
Once you access the LCD, the "Coding Guidelines" can be found under the heading, "LCD Attachments" near the end of the document. Note: All CPT/HCPCS codes listed are mentioned in the LCD, but are not necessarily subject to diagnosis codes or coverage criteria.
LCD Title | LCD Number | Billing and Coding Companion Article | CPT / HCPCS Codes Referenced |
---|---|---|---|
MolDX: Biomarkers in Cardiovascular Risk Assessment | L36362 | A57055 | 82172, 82610, 83090, 83695, 83698, 83700, 83701, 83704, 83719, 83721, 86141 |
MolDX: Blood Product Molecular Antigen Typing | L38333 | A57376 | 81105, 81106, 81107, 81108, 81109, 81110, 81111, 81112, 81403, 0001U, 0084U, 0180U, 0181U, 0182U, 0183U, 0814U, 0185U, 0186U, 0187U, 0188U, 0189U, 0190U, 0191U, 0192U, 0193U, 0194U, 0195U, 0196U, 0197U, 0198U, 0199U, 0200U, 0201U, 0221U, 0222U |
MolDX: Breast Cancer Assay: Prosigna | L36386 | A57364 | 81520 |
MolDX: Breast Cancer IndexTM (BCI) Gene Expression Test | L37824 | A57774 | 81518 |
MolDX: Decision Dx-UM (Uveal Melanoma) | L37072 | A57622 | 81552 |
MolDX: EndoPredict® Breast Cancer Gene Expression Test | L37311 | A57608 | 81522 |
MolDX: Envisia, Veracyte, Idiopathic Pulmonary Fibrosis Diagnostic Test | L37891 | A57420 | 81554 |
MolDX: Gene Expression Profile Tests for Decision-Making in Castration Resistant and Metastatic Prostate Cancers | L39688 | A59515 | 81479, 81452 |
MolDX: Genetic Testing for BCR-ABL Negative Myeloproliferative Disease | L36186 | A57422 | 81206, 81207, 81208, 81219, 81270, 81279, 81338, 81339, 81450, 81479, 81599, 0027U, 0040U |
MolDX: Genetic Testing for Hypercoagulability/Thrombophilia (Factor V Leiden, Factor II Prothrombin, and MTHFR | L36159 | A57424 | 81240, 81241, 81291 |
MolDX: HLA-DQB1*06:02 Testing for Narcolepsy | L36544 | A57465 | 81383 |
MolDX: Inivata, InVisionFirst, Liquid Biopsy for Patients with Lung Cancer | L37899 | A57665 | 81479, 0388U |
MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer | L38974 | A58681 | 81202, 81215, 81217, 81293, 81296, 81299, 81308, 81318, 81322, 81353, 81403, 81404, 81405, 81406, 81432, 81433, 81435, 81436, 81437, 81438, 81479, 0101U, 0102U, 0103U, 0129U, 81163, 81164, 81165, 81166, 81167, 81201, 81203, 81212, 81216, 81292, 81294, 81295, 81297, 81298, 81300, 81307, 81317, 81319, 81321, 81323, 81351 |
MolDX: Melanoma risk Stratification Molecular Testing | L37748 | A57290 | 81529 |
MolDX: MGMT Promoter Methylation Analysis | L36192 | A57433 | 81287 |
MolDX: Minimal Residual Disease Testing for Cancer | L38816 | A58456 | 81445, 81479, 0340U, 0356U, 0422U |
MolDX: Molecular Assays for the Diagnosis of Cutaneous Melanoma | L39375 | A59181 | 81479, 0090U, 0314U |
MolDX: Molecular Biomarker Testing for Risk Stratification of Cutaneous Squamous Cell Carcinoma | L39594 | A59401 | 81479, 0315U |
MolDX: Molecular Biomarker Testing to Guide Targeted Therapy Selection in Rheumatoid Arthritis | L39469 | A59522 | 81599, 0456U |
MolDX: Molecular Biomarkers for Risk Stratification of Indeterminate Pulmonary Nodules Following Bronchoscopy | L39680 | A59507 | 81479 |
MolDX: Molecular Biomarkers to Risk-Stratify Patients at Increased Risk for Prostate Cancer | L39007 | A58724 | 81313, 81479, 81551, 0005U, 0339U |
MolDX: Molecular Diagnostic Tests (MDT) | L36256* | A57527 | 81105, 81106, 81107, 81108, 81109, 81110, 81111, 81112, 81120, 81121, 81161, 81162, 81163, 81164, 81165, 81166, 81167, 81168, 81170, 81171, 81172, 81173, 81174, 81175, 81176, 81177, 81178, 81179, 81180, 81181, 81182, 81183, 81184, 81185, 81186, 81187, 81188, 81189, 81190, 81191, 81192, 81193, 81194, 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, 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, 81278, 81279, 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, 81338, 81339, 81340, 81341, 81342, 81343, 81344, 81345, 81346, 81347, 81348, 81349, 81350, 81351, 81352, 81353, 81355, 81357, 81360, 81361, 81362, 81363, 81364, 81374, 81377, 81381, 81383, 81400, 81401, 81402, 81403, 81404, 81405, 81406, 81407, 81408, 81410, 81411, 81412, 81413, 81414, 81415, 81416, 81417, 81419, 81420, 81422, 81425, 81426, 81427, 81430, 81431, 81432, 81433, 81434, 81435, 81436, 81437, 81438, 81439, 81440, 81441, 81442, 81443, 81445, 81448, 81449, 81450, 81451, 81455, 81456, 81460, 81465, 81470, 81471, 81479, 81493, 81504, 81507, 81518, 81519, 81520, 81521, 81522, 81523, 81525, 81528, 81529, 81540, 81541, 81542, 81546, 81551, 81552, 81554, 81595, 0004M, 0006M, 0007M, 0011M, 0012M, 0013M, 0016M, 0017M, 0020M, 0001U, 0005U, 0016U, 0017U, 0018U, 0019U, 0022U, 0023U, 0026U, 0027U, 0029U, 0030U, 0031U, 0032U, 0033U, 0034U, 0036U, 0037U, 0040U, 0045U, 0046U, 0047U, 0048U, 0049U, 0050U, 0055U, 0060U, 0069U, 0070U, 0071U, 0072U, 0073U, 0074U, 0075U, 0076U, 0079U, 0084U, 0087U, 0088U, 0089U, 0090U, 0091U, 0094U, 0101U, 0102U, 0103U, 0111U, 0112U, 0113U, 0114U, 0118U, 0120U, 0129U, 0130U, 0131U, 0132U, 0133U, 0134U, 0135U, 0136U, 0137U, 0138U, 0152U, 0153U, 0154U, 0155U, 0156U, 0157U, 0158U, 0159U, 0160U, 0161U, 0162U, 0169U, 0170U, 0171U, 0172U, 0173U, 0175U, 0177U, 0179U, 0180U, 0181U, 0182U, 0183U, 0184U, 0185U, 0186U, 0187U, 0188U, 0189U, 0190U, 0191U, 0192U, 0193U, 0194U, 0195U, 0196U, 0197U, 0198U, 0199U, 0200U, 0201U, 0203U, 0205U, 0209U, 0211U, 0212U, 0213U, 0214U, 0215U, 0216U, 0217U, 0218U, 0221U, 0222U, 0229U, 0230U, 0231U, 0232U, 0233U, 0234U, 0235U, 0236U, 0237U, 0238U, 0239U, 0242U, 0244U, 0245U, 0246U, 0250U, 0258U, 0260U, 0262U, 0264U, 0265U, 0266U, 0267U, 0268U, 0269U, 0270U, 0271U, 0272U, 0273U, 0274U, 0276U, 0277U, 0278U, 0282U, 0285U, 0286U, 0287U, 0288U, 0289U, 0290U, 0291U, 0292U, 0293U, 0294U, 0296U, 0297U, 0298U, 0299U, 0300U, 0306U, 0307U, 0313U, 0314U, 0315U, 0318U, 0319U, 0320U, 0321U, 0323U, 0326U, 0327U, 0329U, 0330U, 0331U, 0332U, 0333U, 0335U, 0336U, 0339U, 0340U, 0341U, 0347U, 0348U, 0349U, 0350U, 0355U, 0356U, 0362U, 0363U, 0439U, 0440U, 0444U, 0448U, 0449U, 0452U, 0453U, 0454U, 0455U, 0456U, 0460U, 0461U, 0463U, 0464U, 0465U, 0466U, 0467U, 0469U, 0470U, 0471U, 0473U, 0474U, 0475U, 0476U, 0477U, 0478U, 0480U, 0481U, 0485U, 0486U, 0487U, 0488U, 0489U, 0490U, 0491U, 0492U, 0493U, 0494U, 0495U, 0496U, 0497U, 0498U, 0499U, 0500U, 0501U, 0504U, 0505U, 0506U, 0507U, 0508U, 0509U, 0510U, 0511U, 0516U |
MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing | L39003 | A58726 | 87631, 87636, 87637, 87801, 0240U, 0241U, 87505, 87483, 87154, 81513, 81514, 87800, 87801, 87999, 0352U, 87632, 87633, 0115U, 0202U, 0223U, 0225U, 87149, 87150, 87153, 87506, 87507, 87468, 87469, 87471, 87472, 87475, 87476, 87478, 87480, 87481, 87482, 87484, 87485, 87486, 87487, 87490, 87491, 87492, 87493, 87495, 87496, 87497, 87498, 87501, 87502, 87503, 87510, 87511, 87512, 87516, 87517, 87520, 87521, 87522, 87523, 87525, 87526, 87527, 87528, 87529, 87530, 87531, 87532, 87533, 87534, 87535, 87536, 87537, 87538, 87539, 87540, 87541, 87542, 87550, 87551, 87552, 87555, 87556, 87557, 87560, 87561, 87562, 87563, 87580, 87581, 87582, 87590, 87591, 87592, 87593, 87623, 87624, 87625, 87634, 87635, 87640, 87641, 87650, 87651, 87652, 87653, 87660, 87661, 87662, 87797, 87798, 87799, U0001, U0002, 0402U, 0429U, 0455U |
MolDX: Molecular Testing for Detection of Upper Gastrointestinal Metaplasia, Dysplasia, and Neoplasias | L39264 | A59034 | 81479, 0114U |
MolDX: Molecular Testing for Solid Organ Allograft Rejection | L38671 | A58170 | 81479, 81595, 81599, 0118U |
MolDX: Molecular Testing for Risk Stratification of Thyroid Nodules | L39684 | A59511 | 81546, 81479 |
MolDX: Next-Generation Sequencing for Solid Tumors | L38121 | A57905 | 81445, 81449, 81479, 81457, 81458, 81459, 0244U, 0250U, 0329U, 0334U, 0379U |
MolDX: Next-Generation Sequencing Lab-Developed Tests for Myeloid Malignancies and Suspected Myeloid Malignancies | L38125 | A57892 | 81450, 81451, 81479 |
MolDX: NRAS Genetic Testing | L36339 | A57487 | 81311, 81479 |
MolDX: Oncotype DX® Breast Cancer for (DCIS) Genomic Health™ | L36947 | A57620 | 0045U |
MolDX: Pharmacogenomics Testing | L38337 | A57385 | 81225, 81226, 81227, 81231, 81232, 81247, 81283, 81306, 81328, 81335, 81350, 81355, 81374, 81377, 81381, 81383, 81401, 81406, 81418, 81479, 0029U, 0030U, 0034U, 0070U, 0071U, 0072U, 0073U, 0074U, 0075U, 0076U, 0286U, 0345U, 0380U, 0411U, 0419U |
MolDX: Phenotypic Biomarker Detection in Circulating Tumor Cells | L38645 | A58185 | 81479 |
MolDX: Pigmented Lesion Assay | L38153 | A58053 | 0089U |
MolDX: Plasma-Based Genomic Profiling in Solid Tumors | L39232 | A58975 | 81445, 81479, 0326U, 0179U, 0409U, 0428U, 0485U, 0487U |
MolDX: Predictive Classifiers for Early Stage Non-Small Cell Lung Cancer | L38329 | A57330 | 81479, 0288U |
MolDX: Prognostic and Predictive Molecular Classifiers for Bladder Cancer | L38649 | A58187 | 81401, 81403, 81404, 81445, 81479, 0016M |
MolDX: Prometheus IBD sgi Diagnostic Policy | L37313 | A57517 | 81479, 82397, 83520, 86140 |
MolDX: Prostate Cancer Genomic Classifier Assay for Men with Localized Disease | L38341 | A57236 | 81541, 81542, 0047U |
MolDX: Repeat Germline Testing | L38353 | A57332 | 81105, 81106, 81107, 81108, 81109, 81110, 81111, 81112, 81161, 81162, 81163, 81164, 81165, 81166, 81167, 81171, 81172, 81173, 81174, 81177, 81178, 81179, 81180, 81181, 81182, 81183, 81184, 81185, 81186, 81187, 81188, 81189, 81190, 81200, 81201, 81202, 81203, 81204, 81205, 81209, 81212, 81215, 81216, 81217, 81220, 81221, 81222, 81223, 81224, 81225, 81226, 81227, 81228, 81229, 81230, 81231, 81232, 81233, 81234, 81238, 81239, 81240, 81241, 81242, 81243, 81244, 81247, 81248, 81249, 81250, 81251, 81252, 81253, 81254, 81255, 81256, 81257, 81258, 81259, 81260, 81269, 81271, 81274, 81283, 81284, 81285, 81286, 81289, 81290, 81291, 81292, 81293, 81294, 81295, 81296, 81297, 81298, 81299, 81300, 81302, 81303, 81304, 81306, 81307, 81309, 81312, 81317, 81318, 81319, 81321, 81322, 81323, 81324, 81325, 81326, 81328, 81329, 81330, 81331, 81332, 81333, 81335, 81336, 81337, 81343, 81344, 81346, 81350, 81355, 81361, 81362, 81363, 81364, 81410, 81411, 81412, 81413, 81414, 81415, 81418, 81419, 81425, 81430, 81431, 81432, 81433, 81434, 81435, 81436, 81437, 81438, 81439, 81440, 81441, 81442, 81443, 81448, 81460, 81465, 81470, 81471, 81479, 81493, 81554, 0004M, 0001U, 0029U, 0030U, 0031U, 0032U, 0033U, 0034U, 0070U, 0071U, 0072U, 0073U, 0074U, 0075U, 0076U, 0078U, 0079U, 0084U, 0094U, 0101U, 0102U, 0103U, 0129U, 0130U, 0131U, 0132U, 0133U, 0134U, 0135U, 0136U, 0137U, 0138U, 0156U, 0157U, 0158U, 0159U, 0160U, 0161U, 0162U, 0169U, 0170U, 0173U, 0175U, 0180U, 0181U, 0182U, 0183U, 0184U, 0185U, 0186U, 0187U, 0188U, 0189U, 0190U, 0191U, 0192U, 0193U, 0194U, 0195U, 0196U, 0197U, 0198U, 0199U, 0200U, 0201U, 0203U, 0205U, 0209U, 0212U, 0213U, 0214U, 0215U, 0216U, 0217U, 0218U, 0221U, 0222U, 0230U, 0231U, 0232U, 0233U, 0234U, 0235U, 0236U, 0237U, 0238U, 0246U, 0258U, 0260U, 0264U, 0265U, 0266U, 0267U, 0268U, 0269U, 0270U, 0271U, 0272U, 0273U, 0274U, 0276U, 0277U, 0278U, 0282U, 0286U, 0289U, 0290U, 0291U, 0292U, 0293U, 0294U, 0318U, 0345U 0347U, 0348U, 0349U, 0350U, 0355U, 0378U, 0380U, 0389U, 0392U, 0400U, 0401U, 0411U, 0417U, 0419U, 0425U, 0426U, 0439U, 0440U, 0449U, 0454U, 0460U, 0461U, 0474U, 0475U |
Last Updated Oct 03 , 2024