MedicaidCoverageHigh impact
Molecular Diagnostic Assays and Breath Testing for Transplant Rejection - MEDICAID - LOUISIANA (New)
Humana·LA · Transplant Surgery, Nephrology, Cardiology +1 more·Medicaid
Effective date
Jan 1, 2025
We identified it
Jun 24, 2026
Summary
Louisiana Medicaid has established a new policy effective January 1, 2025 that denies coverage for all molecular diagnostic assays and breath testing for transplant rejection monitoring. All listed tests and procedures are considered not covered due to insufficient evidence.
Action Required
Immediately: Billing team must update system to deny all molecular diagnostic and breath testing claims for transplant rejection monitoring for Louisiana Medicaid patients. Flag all affected CPT codes (81378, 81379, 81479, 81560, 81599) and PLA codes (0001U, 0018M, 0055U, 0084U, 0087U, 0118U, 0319U) as non-covered. Notify providers that these tests will not be reimbursed and should not be ordered for Louisiana Medicaid beneficiaries.