Local Coverage DeterminationOncology

LCD L38643: MolDX: Phenotypic Biomarker Detection from Circulating Tumor Cells — Noridian

LCD-L38643

Document details

Document type
Local Coverage Determination
Issuing body
MAC Contractor
Document ID
LCD-L38643
Published
June 5, 2026
Effective date
February 5, 2026
MAC region
Noridian

Summary

The implementation of the MolDX LCD for phenotypic biomarker detection may significantly impact billing processes by introducing new HCPCS codes and reimbursement policies. Providers must update their

New billing guidelines for circulating tumor cells from 2026.

Affected codes

ICD-10-CM

Affected specialty

Oncology alerts →

Source document

https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=38643&ver=8

CLV Intelligence summarizes publicly available federal publications. Not affiliated with or endorsed by any government agency.

Related alerts

4

FDA Approval: TRELSTAR (TRIPTORELIN PAMOATE) — Type 3 - New Dosage Form

Policy FDA-NDA022437 · Oncology

Critical

Trelstar (triptorelin pamoate) is an intramuscular injectable GnRH agonist indicated for advanced prostate cancer, billing under Medicare Part B as a physician-administered drug. As an established inj

View alert

FDA Approval: TRELSTAR (TRIPTORELIN PAMOATE) — Type 3 - New Dosage Form

Policy FDA-NDA021288 · Oncology

Critical

Trelstar (triptorelin pamoate) is an intramuscular injectable approved for a new dosage form under NDA021288, placing it firmly in the Medicare Part B billing pathway as a physician-administered drug.

View alert

FDA Approval: TRELSTAR (TRIPTORELIN PAMOATE) — Type 1 - New Molecular Entity

Policy FDA-NDA020715 · Oncology

Critical

Trelstar (triptorelin pamoate) is an intramuscular injectable indicated for prostate cancer, placing it squarely in the Medicare Part B billing pathway as a physician-administered drug. It is typicall

View alert

FDA Approval: ROMVIMZA (VIMSELTINIB) — Type 1 - New Molecular Entity

Policy FDA-NDA219304 · Oncology

High

Romvimza (vimseltinib) is an oral capsule kinase inhibitor approved via NDA219304, placing it squarely in the Medicare Part D billing pathway as a self-administered outpatient drug. As a new molecular

View alert