Tuesday, January 25, 2022

Brief Blog: Noridian Issues Plasma-Based Genomic Profiling LCD, Will Eventually Match the Rest of MolDx

The MolDx system for genomic policies includes four MACs, Palmetto (where full time MolDx staff are found), Noridian, WPS, and CGS.  

Generally, the four MACs release LCDs in lockstep.  However, back around 2020, Noridian began releasing some coverage decisions as "articles" which quoted the key coverage text found in "LCDs" in the other three MACs.   

  • For example, Palmetto, WPS, and CGS would each have an LCD covering "Gene ABC" and Noridian, instead, would have a matching article covering "Gene ABC."

With the release of DL39230 and DL39232 on January 20, 2022, Noridian starts the path to having an LCD for "plasma based genomic profiling in solid tumors" that will match already-existing and similar LCDs in the other MolDx MACs.

MRD and other forms of early detection are getting a good response at ASCO, per a January 26, 2022 article in Precision Oncology News by Molika Ashford - here.

Find LCD DL39230 and LCD DL39232 .   Comment period is open to March 5, 2022.  See the Noridian website to look for a promised public meeting (teleconference) on January 24.

The current master LCD, the Palmetto LCD, is L38043.  The Noridian drafts match the current master Palmetto LCD.

Nerdy Detail - Noridian releases one LCD for Jurisdiction E (CA/NV/HI) and one LCD for Jurisdiction F (mountain states), which is why we see LCD '230 and also its twin '232.