Traditional MedicareCoverageMedium impact
MolDX: Molecular Testing for Solid Organ Allograft Rejection
Medicare/CMS - LCD·Transplant Surgery, Nephrology·Local Coverage Determination
Effective date
Aug 30, 2026
We identified it
Jul 16, 2026
Summary
This is a NEW Local Coverage Determination (LCD L40060) from Noridian Healthcare Solutions establishing coverage criteria for molecular testing (MolDX) to detect solid organ allograft rejection. The policy becomes effective 8/30/2026 and applies to Medicare Part A and Part B beneficiaries in Noridian's service region. Billing teams must understand which molecular testing codes are now covered under this new LCD and any prior authorization or documentation requirements.
Action Required
By August 29, 2026: (1) Billing team must review the complete LCD L40060 policy text at the provided CMS link to identify specific CPT/HCPCS codes for molecular allograft rejection testing that are now covered. (2) Update billing system rules and claim submission guidelines to reflect Noridian's coverage requirements for this new LCD. (3) Determine if prior authorization is required for these tests and configure billing software accordingly. (4) Communicate with transplant surgery providers and nephrology staff about the new coverage effective date and any documentation requirements. (5) Train front desk and authorization staff on new coverage criteria. Failure to comply may result in claim denials or payment delays for allograft rejection molecular testing claims submitted on or after the effective date.