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Local Coverage Determinations Roundup: Transplant Genomics

NEW YORK – One Medicare Administrative Contractor finalized a local coverage determination (LCD) in line with Palmetto’s MolDx program.

Below is a description of the LCD.

Final LCD: 

Wisconsin Physicians Service Insurance Corporation: Transplant Genomics' TruGraf Blood Gene Expression test

The contractor has issued a final coverage decision in line with Palmetto's LCD. In a final LCD in October Palmetto had agreed to cover the test for kidney transplant patients who are 18 years of age or older, has stable creatinine levels 90 days after receiving the transplant and are being managed in a facility that performs surveillance biopsies. TruGraf is a DNA microarray test that assesses differentially expressed genes in blood to rule out kidney transplant rejection in patients with stable renal function, providing an alternative to surveillance biopsies.

**Palmetto administers the MolDX program, in which three other Medicare Administrative Contractors (MACs) participate, including Noridian, CGS, and Wisconsin Physicians Service Insurance Corporation. Each MAC issues its own draft and final policy to align with Palmetto’s coverage terms for a specific test.