Since 2012, Medicare has supported a distinctive local contractor-based coverage and coding program called MOLDX. The program was originally created by the Palmetto GBA program for us in Jurisdiction 1 - California, Hawaii, Nevada - from 2012 to 2013. Palmetto GBA now also operates the program in its "home states" of SC, NC, VA and WV, and the program are also valid for labs in the new Jurisdiction E (CA, HI, NV) -- states where the laboratory's claims are actually processed by the Noridian contractor (
here).
In June 2014, the MOLDX program (which has its own website,
here) published several guidance documents for labs submitting new-test dossiers and publications for coverage decisions.
In addition, the MOLDX program published an innovative draft LCD (DL35368) providing coverage for the
MDxHealth test ConfirmMDX.
ConfirmDX helps rules out the need for repeat biopsies in cases of potential prostate cancer.
Links and more after the break.
