Wednesday, May 18, 2016

Noridian MolDX Posts, Withdraws, Consolidated Breast Cancer LCD Mirroring ASCO Guidelines

Noridian Jurisdiction E (including California) posted a draft LCD which appears to consolidate coverage for breast cancer prognostic markers, early in the week of May 16, 2016.  

The LCD was posted online at CMS here.  However, according to several sources, Noridian is canceling this LCD for this LCD cycle.

An archival copy of the May 16 LCD is in the cloud, here.

The proposal for a single breast cancer biomarker LCD very closely matched Medicare coverage to February 2016 ASCO guidelines for breast cancer prognostic markers - regardless of whether that guideline is broader or narrower than existing Medicare LCD coverage.  (For the ASCO document, see Harris et al., here.)

A listing of all current draft LCDs in J-E is here.  For this LCD cycle, there is an open comment period from June 2, 2016, to August 8, 2016.