Medicare local coverage
Medicare coverage for MolDX: Prognostic and Predictive Molecular Classifiers for Bladder Cancer (LCD)
4 Medicare Administrative Contractors publish a local coverage determination (LCD) for MolDX: Prognostic and Predictive Molecular Classifiers for Bladder 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 | L38586 | Active | May 11, 2026 |
Noridian Healthcare Solutions, LLCMAC - Part A, MAC - Part B | L38647 | Active | Apr 7, 2026 |
Noridian Healthcare Solutions, LLCMAC - Part A, MAC - Part B | L38649 | Retired Feb 5, 2026 | Feb 5, 2026 |
Palmetto GBAMAC - Part A, MAC - Part B | L38576 | Active | Apr 7, 2026 |
WPS Insurance CorporationMAC - Part A, MAC - Part B | L38684 | Active | Apr 10, 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.
- A58028Palmetto GBAUpdated Jan 8, 2024
- A58065CGS Administrators, LLCUpdated Jan 8, 2024
- A58181Noridian Healthcare Solutions, LLCUpdated Jan 26, 2026
- A58187Noridian Healthcare Solutions, LLCUpdated Feb 5, 2026
- A58211WPS Insurance CorporationUpdated Dec 11, 2025
CMS also lists 9 response-to-comments articles for this topic, where contractors answer public comments on the proposed LCD: A58729, A58735, A58748, A58749, A59408, A59437, A59452, A59453, A59456.
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: Predictive Classifiers for Early Stage Non-Small Cell Lung Cancer
- MolDX: Molecular Biomarkers to Risk-Stratify Patients at Increased Risk for Prostate Cancer
- MolDX: Non-Next Generation Sequencing Targeted Molecular Panel Tests for Targeted Therapy in Cancer
- Bladder/Urothelial Tumor Markers
- 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.