The following Local Coverage Determination (LCD) has completed the Open Public and Contractor Advisory Committee (CAC) comment period and is now finalized under contractor numbers 01112 (NCA), 01182 (SCA), 01212 (AS, GU, HI, NMI), 01312 (NV). Responses to comments received may be found as a link at the bottom of the final LCD.
Medicare Coverage Database (MCD) Number/Contractor Determination Number: L37301
LCD Title: MolDX: Multiplex Nucleic Acid Amplified Tests for Respiratory Viral Panels
Effective Date: May 13, 2019
Summary of LCD: This policy limits coverage of multiplex polymerase chain reaction (PCR) respiratory viral panels. Panels of 3-5 pathogens are covered under limited circumstances. Specifically, the test must be ordered either in a healthcare setting that is equipped to care for and routinely does care for critically ill patients, or it must be ordered by an infectious disease specialist, unless an infectious disease specialist is not available. Multiplex PCR respiratory viral panels of 6 or more pathogens are non-covered.