Medicare local coverage
Medicare coverage for Biomarkers for Oncology (LCD)
One Medicare Administrative Contractor, Novitas Solutions, Inc., publishes a local coverage determination (LCD) for Biomarkers for Oncology. The snapshot lists 1 LCD record: 1 active.
An LCD applies only in the jurisdiction of the contractor that wrote it. Two contractors can cover the same service with different criteria, documentation requirements and covered diagnoses, so check the LCD from the contractor that processes your claims.
LCDs by contractor
| Contractor | LCD | Status | Last updated |
|---|---|---|---|
Novitas Solutions, Inc.MAC - Part A, MAC - Part B | L35396 | Active | Apr 17, 2025 |
An LCD marked Future has been finalized and is in its notice period; it applies from the effective date shown. LCD IDs link to the record on cms.gov.
Billing and coding articles
The codes live in the billing and coding article that goes with each LCD: the CPT and HCPCS codes the policy applies to, the ICD-10 codes that support medical necessity, and any modifier or documentation rules.
- A52986Novitas Solutions, Inc.Updated Apr 25, 2025
Check claim lines against Medicare coverage
Coverage Check tells you whether a claim's diagnoses support Medicare LCD or NCD coverage for each procedure line, and shows the policy and CMS source behind each answer.
Related LCD topics
- Biomarkers Overview
- Genetic Testing in Oncology: Specific Tests
- MolDX: Biomarkers in Cardiovascular Risk Assessment
- MolDX: Molecular Biomarkers for Risk Stratification of Indeterminate Pulmonary Nodules Following Bronchoscopy
- MolDX: Molecular Biomarkers to Risk-Stratify Patients at Increased Risk for Prostate Cancer
- Multiple Imaging in Oncology
All Medicare LCD topics · National coverage determinations · Payer policies by payer
Source: CMS Medicare Coverage Database, via the public CMS Coverage API, snapshot Oct 25, 2026. LCDs change between snapshots; confirm the version in effect for your date of service on cms.gov before billing.