Traditional MedicareCoverageMedium impact
MolDX: Molecular Biomarkers for Risk Stratification of Indeterminate Pulmonary Nodules Following Bronchoscopy
Medicare/CMS - LCD·Pulmonology, Oncology·Local Coverage Determination
Effective date
Jun 18, 2026
We identified it
Jun 23, 2026
Summary
New Local Coverage Determination establishes Medicare coverage criteria for molecular biomarker tests used to assess cancer risk in lung nodules found during bronchoscopy procedures. This affects pulmonology practices performing bronchoscopies and ordering specialized molecular diagnostic tests for indeterminate pulmonary nodules.
Action Required
By June 18, 2026: Pulmonology providers must review new coverage criteria for molecular biomarker tests used after bronchoscopy for indeterminate pulmonary nodules. Update documentation requirements and ensure medical necessity criteria are met before ordering these specialized tests. Billing team should verify coverage requirements with CGS Administrators for Medicare patients needing these molecular diagnostic services.