Traditional MedicareCoverageMedium impact
MolDX: Pigmented Lesion Assay
Medicare/CMS - LCD·Dermatology, Pathology, Diagnostic Imaging·Local Coverage Determination
Effective date
Apr 30, 2026
We identified it
Jun 17, 2026
Summary
This is a new Local Coverage Determination (LCD) for Pigmented Lesion Assay testing under the MolDX program, which establishes coverage criteria for molecular diagnostic tests used to evaluate suspicious skin lesions. The policy will determine when Medicare will cover these specialized tests for skin cancer diagnosis.
Action Required
By April 30, 2026: Billing team must review the full LCD L38178 policy details to understand coverage criteria for pigmented lesion assays. Update prior authorization workflows if required and ensure documentation requirements are met for Medicare patients receiving these molecular diagnostic tests. Coordinate with dermatology providers to ensure compliance with new coverage criteria.