Medicare local coverage
Medicare coverage for MolDX: Phenotypic Biomarker Detection from Circulating Tumor Cells (LCD)
3 Medicare Administrative Contractors publish a local coverage determination (LCD) for MolDX: Phenotypic Biomarker Detection from Circulating Tumor Cells. The snapshot lists 4 LCD records: 3 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 | L38584 | Active | Apr 6, 2026 |
Noridian Healthcare Solutions, LLCMAC - Part A, MAC - Part B | L38645 | Retired Feb 5, 2026 | Feb 5, 2026 |
Noridian Healthcare Solutions, LLCMAC - Part A, MAC - Part B | L38643 | Active | Jan 26, 2026 |
WPS Insurance CorporationMAC - Part A, MAC - Part B | L38678 | Active | Jun 18, 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.
- A58021Palmetto GBAUpdated May 26, 2022
- A58063CGS Administrators, LLCUpdated Nov 10, 2023
- A58183Noridian Healthcare Solutions, LLCUpdated Jan 26, 2026
- A58185Noridian Healthcare Solutions, LLCUpdated Feb 24, 2026
- A58205WPS Insurance CorporationUpdated May 21, 2026
CMS also lists 5 response-to-comments articles for this topic, where contractors answer public comments on the proposed LCD: A58728, A58743, A58781, A58782, A58792.
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: Phenotypic Biomarker Detection in Circulating Tumor Cells
- Automated Detection and Quantification of Brain MRIs
- Bladder/Urothelial Tumor Markers
- Cardiac Event Detection
- Lab: Bladder/Urothelial Tumor Markers
- MolDX: Biomarker Testing in Metabolic Dysfunction-Associated Steatotic Liver Disease and Metabolic Dysfunction-Associated Steatohepatitis
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.