Medicare local coverage
Medicare coverage for MolDX: Next-Generation Sequencing for Solid Tumors (LCD)
4 Medicare Administrative Contractors publish a local coverage determination (LCD) for MolDX: Next-Generation Sequencing for Solid Tumors. 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 | L38067 | Active | Aug 15, 2025 |
Noridian Healthcare Solutions, LLCMAC - Part A, MAC - Part B | L38121 | Retired Feb 5, 2026 | Feb 5, 2026 |
Noridian Healthcare Solutions, LLCMAC - Part A, MAC - Part B | L38119 | Active | Jan 26, 2026 |
Palmetto GBAMAC - Part A, MAC - Part B | L38045 | Active | Jun 2, 2023 |
WPS Insurance CorporationMAC - Part A, MAC - Part B | L38158 | Active | Jun 22, 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.
- A57831Palmetto GBAUpdated Sep 14, 2026
- A57858WPS Insurance CorporationUpdated Sep 17, 2026
- A57870CGS Administrators, LLCUpdated Sep 15, 2026
- A57901Noridian Healthcare Solutions, LLCUpdated Sep 14, 2026
- A57905Noridian Healthcare Solutions, LLCUpdated Mar 5, 2026
CMS also lists 4 response-to-comments articles for this topic, where contractors answer public comments on the proposed LCD: A57830, A57876, A57904, A57906.
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: Next-Generation Sequencing Lab-Developed Tests for Myeloid Malignancies and Suspected Myeloid Malignancies
- MolDX: Non-Next Generation Sequencing Targeted Molecular Panel Tests for Targeted Therapy in Cancer
- MolDX: Non-Next Generation Sequencing Tests for the Diagnosis of BCR-ABL Negative Myeloproliferative Neoplasms
- MolDX: Plasma-Based Genomic Profiling in Solid Tumors
- Genomic Sequence Analysis Panels in the Treatment of Solid Organ Neoplasms
- MolDX: Molecular Testing for Solid Organ Allograft Rejection
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.