Traditional MedicareCoverageMedium impact
MolDX: Non-Next Generation Sequencing Tests for the Diagnosis of BCR-ABL Negative Myeloproliferative Neoplasms
Medicare/CMS - LCD·Hematology, Oncology, Pathology·Local Coverage Determination
Effective date
Jun 18, 2026
We identified it
Jun 23, 2026
Summary
Medicare Local Coverage Determination L40000 establishes coverage criteria for non-Next Generation Sequencing tests used to diagnose BCR-ABL negative myeloproliferative neoplasms. This policy affects specialized molecular diagnostic testing billing for blood cancer diagnostics.
Action Required
Before June 18, 2026: Review current billing practices for molecular diagnostic tests used in myeloproliferative neoplasm diagnosis. Billing team should verify coverage criteria and documentation requirements for non-NGS tests. Ensure proper medical necessity documentation is in place for affected molecular diagnostic claims to prevent denials.