Medicare local coverage
Medicare coverage for MolDX: HLA-DQB1*06:02 Testing for Narcolepsy (LCD)
4 Medicare Administrative Contractors publish a local coverage determination (LCD) for MolDX: HLA-DQB1*06:02 Testing for Narcolepsy. 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 | L36485 | Active | Jul 8, 2026 |
Noridian Healthcare Solutions, LLCMAC - Part A, MAC - Part B | L36544 | Retired Jan 22, 2026 | Jan 22, 2026 |
Noridian Healthcare Solutions, LLCMAC - Part A, MAC - Part B | L36551 | Active | Jan 12, 2026 |
Palmetto GBAMAC - Part A, MAC - Part B | L36464 | Active | Aug 16, 2023 |
WPS Insurance CorporationMAC - Part A, MAC - Part B | L37003 | Active | Aug 23, 2023 |
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.
- A56857Palmetto GBAUpdated Jun 30, 2021
- A56881CGS Administrators, LLCUpdated Jul 31, 2025
- A57441Noridian Healthcare Solutions, LLCUpdated Jan 12, 2026
- A57465Noridian Healthcare Solutions, LLCUpdated Jan 22, 2026
- A57575WPS Insurance CorporationUpdated Jun 18, 2025
CMS also lists 1 response-to-comments article for this topic, where contractors answer public comments on the proposed LCD: A54813.
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.
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.