News-At-A-Glance: Noridian Issues Molecular and Genetic Test LCDs

Noridian Health Solutions (NHS), one of the largest Part B Medicare Administrative Contractors (MAC), has issued draft Part B local coverage determinations (LCDs) for certain molecular and genetic tests. NHS released draft policies for public comments for CYP2C19, CYP2D6, CYP2C9, and VKORC1 Genetic Testing; MolDx Breast Cancer Genetic Assay (PBT22); MolDx Prostate Cancer Genetic Assay (ZBE44); and MolDx Genetic Assay for Refractory Depression. The comment period starts Sept. 3 and ends Nov. 3. The reason for issuing the LCDs, as stated in the policies, is to create uniform LCDs with other MAC jurisdictions. The three MolDx LCDs are derived from policies that have been posted on the Palmetto GBA Web site for MAC Jurisdiction 11. NHS covers Alaska, Arizona, Idaho, Montana, North Dakota, Oregon, South Dakota, Utah, Washington, and Wyoming. Clinical laboratories that file claims for the listed tests in this MAC’s jurisdiction should review the policies and comment on them if there are any problems or issues. A hospital that must file claims for its inpatients or outpatients for tests performed in reference labs should forward the policies to the reference lab for any comments they may have regarding the tests and to make them aware of the diagnostic requirements.