Medicare local coverage
Medicare coverage for Respiratory Pathogen Panel Testing (LCD)
3 Medicare Administrative Contractors publish a local coverage determination (LCD) for Respiratory Pathogen Panel Testing. The snapshot lists 3 LCD records: 3 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 |
|---|---|---|---|
First Coast Service Options, Inc.MAC - Part B | L38918 | Active | May 21, 2021 |
Novitas Solutions, Inc.MAC - Part B | L38916 | Active | May 21, 2021 |
Wellpoint FederalMAC - Part B | L39027 | Active | Jul 30, 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.
- A58575Novitas Solutions, Inc.Updated Jan 23, 2026
- A58577First Coast Service Options, Inc.Updated Jan 23, 2026
- A58741Wellpoint FederalUpdated Jul 20, 2026
CMS also lists 3 response-to-comments articles for this topic, where contractors answer public comments on the proposed LCD: A58769, A58770, A58890.
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
- Multiplex Gastrointestinal Pathogen Panel (GPP) Tests for Acute Gastroenteritis (AGE)
- Gastrointestinal Pathogen (GIP) Panels Utilizing Multiplex Nucleic Acid Amplification Techniques (NAATs)
- Hepatic (Liver) Function Panel
- MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
- MolDX: Non-Next Generation Sequencing Targeted Molecular Panel Tests for Targeted Therapy in Cancer
- Respiratory Assist Devices
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.