Medicare local coverage
Medicare coverage for MolDX: Genetic Testing for Hypercoagulability/Thrombophilia (Factor V Leiden, Factor II Prothrombin, and MTHFR) (LCD)
4 Medicare Administrative Contractors publish a local coverage determination (LCD) for MolDX: Genetic Testing for Hypercoagulability/Thrombophilia (Factor V Leiden, Factor II Prothrombin, and MTHFR). The snapshot lists 5 LCD records: 1 active, 4 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 | L35984 | Active | Jun 11, 2025 |
Noridian Healthcare Solutions, LLCMAC - Part A, MAC - Part B | L36155 | Retired Oct 11, 2026 | Oct 11, 2026 |
Noridian Healthcare Solutions, LLCMAC - Part A, MAC - Part B | L36159 | Retired Jan 22, 2026 | Jan 22, 2026 |
Palmetto GBAMAC - Part A, MAC - Part B | L36089 | Retired Oct 11, 2026 | Oct 11, 2026 |
WPS Insurance CorporationMAC - Part A, MAC - Part B | L36400 | Retired Oct 11, 2026 | Oct 11, 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.
- A56899Palmetto GBAUpdated Oct 11, 2026
- A56980CGS Administrators, LLCUpdated Jun 11, 2025
- A57423Noridian Healthcare Solutions, LLCUpdated Oct 11, 2026
- A57424Noridian Healthcare Solutions, LLCUpdated Jan 22, 2026
- A57571WPS Insurance CorporationUpdated Oct 11, 2026
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: Genetic Testing for Hereditary Thrombophilia
- BRCA1 and BRCA2 Genetic Testing
- Genetic Testing for Cardiovascular Disease
- Genetic Testing for Lynch Syndrome
- Genetic Testing in Oncology: Specific Tests
- MolDX: Genetic Testing for Heritable Thoracic Aortic Disease
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.