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LCD ID Number: L36807 Status: A-Approved
LCD Title: MolDX: Molecular Diagnostic Tests (MDT)
Geographic Jurisdiction: Missouri - Entire State, Missouri - Northwestern Other Jurisdictions
Original Determination Effective Date:
02/16/2017
Original Determination Ending Date:
Revision Effective Date:
05/29/2025
Revision End Date:
CMS National Coverage Policy:
Title XVIII of the Social Security Act, §1862(a)(1)(A), states that no Medicare payment shall be made for items or services that "are not reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of malformed body member."
Title XVIII of the Social Security Act, §1862(a)(1)(D), Investigational or Experimental.
45 CFR §162.1002 (a)(5), Medical data code sets
CMS Internet-Only Manual, Pub. 100-08, Medicare Program Integrity Manual, Chapter 13, §13.5.4 Reasonable and Necessary Provisions in LCDs
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