Medicare local coverage
Medicare coverage for MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer (LCD)
4 Medicare Administrative Contractors publish a local coverage determination (LCD) for MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer. The snapshot lists 5 LCD records: 4 active, 1 retired.
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 |
|---|---|---|---|
CGS Administrators, LLCMAC - Part A, MAC - Part B | L39017 | Active | Mar 9, 2026 |
Noridian Healthcare Solutions, LLCMAC - Part A, MAC - Part B | L38974 | Retired Feb 5, 2026 | Feb 5, 2026 |
Noridian Healthcare Solutions, LLCMAC - Part A, MAC - Part B | L38972 | Active | Jan 26, 2026 |
Palmetto GBAMAC - Part A, MAC - Part B | L38966 | Active | Apr 12, 2024 |
WPS Insurance CorporationMAC - Part A, MAC - Part B | L39040 | Active | Mar 20, 2026 |
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.
- A58652Palmetto GBAUpdated Jul 28, 2026
- A58679Noridian Healthcare Solutions, LLCUpdated Aug 7, 2026
- A58681Noridian Healthcare Solutions, LLCUpdated Feb 5, 2026
- A58734CGS Administrators, LLCUpdated Jul 30, 2026
- A58756WPS Insurance CorporationUpdated Jul 31, 2026
CMS also lists 4 response-to-comments articles for this topic, where contractors answer public comments on the proposed LCD: A59058, A59063, A59130, A59131.
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
- MolDX: Inivata™, InvisionFirst®, Liquid Biopsy for Patients with Lung Cancer
- MolDX: Molecular Biomarkers to Risk-Stratify Patients at Increased Risk for Prostate Cancer
- MolDX: Next-Generation Sequencing Lab-Developed Tests for Myeloid Malignancies and Suspected Myeloid Malignancies
- Injections - Tendon, Ligament, Ganglion Cyst, Tunnel Syndromes and Morton's Neuroma
- Irreversible Electroporation for Cancer
- Lab: Bladder/Urothelial Tumor Markers
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.