- 4009 Hackney Springs Ln, Sachse, TX 75048
| STATES / TERRITORIES | PHONE · PORTAL | CLAIM VOLUME | BENEFICIARIES |
|---|---|---|---|
| 1-855-252-8782 · Novitasphere JL | ~200 million claims/year | ~3.4 million Medicare FFS |
| LCD | Coverage Area | Key Requirement |
|---|---|---|
| L35025 | MolDX: Molecular Diagnostic Tests (MDT) | Same Z-Code requirement as JE. All molecular diagnostic tests in JF require a DEX Z-Code from Palmetto GBA before billing. |
| L35062 | Glycated Hemoglobin (HbA1c) | Standard quarterly framework. |
| L35095 | Vitamin D Assay | Documentation required. Rural population gaps in primary care documentation make this a common denial source. |
| L34419 | Tumor Markers | Standard policy framework. |
| L35099 | Non-Covered Lab Services | ABN protocol critical given rural access patterns. |
| Test | CPT | Frequency Limit |
|---|---|---|
| HbA1c | 83036 | Quarterly for stable diabetics; monthly for newly diagnosed patients |
| Vitamin D | 82306 | Annual; therapeutic monitoring exception |
| PSA | 84153 | Annual for known prostate cancer monitoring |
| Point-of-care testing (rural POLs) | varies by code | Same frequency rules as full-service labs; CLIA waiver status does not reduce documentation requirements |
Molecular diagnostics MolDX compliance across the jurisdiction’s growing testing volume.
Rural point-of-care testing billing, where documentation gaps are more common than in urban settings.
| Area | Requirement |
|---|---|
| Provider Enrollment | Noridian's enrollment unit in Fargo, ND — the same enrollment infrastructure as JE. CMS-855B for independent labs. |
| ABN Requirements | Standard CMS-R-131. JF has specific guidance for rural labs on ABN issuance for tests with coverage restrictions. |
| CLFS / Fee Schedule | JF covers states with significant rural health clinic and critical access hospital lab billing — these settings have distinct billing rules from standard outpatient labs. |
Labs lose revenue to preventable denials; miscoded panels, missed modifiers, payer-specific mismatches. TransLabs built its billing process around what labs actually need to get paid, coast to coast. Start with a complimentary claims audit. We’ll review your CPT/HCPCS coding, test methodology, and denial trends to show you exactly what’s recoverable.
Claims checked against your MAC's local coverage rules before submission.
Medicaid and commercial prior-auth rules built into your workflow, not discovered after denial.
Appeals strategy built from denial data across all 50 states.
A dedicated billing specialist; never a shared call queue.
Live in 24 hours. No contracts. No upfront fees.
Yes. JF, administered by Noridian Healthcare Solutions, is a MolDX jurisdiction; the same requirement Noridian applies in JE. Labs billing 81XXX-range codes or most PLA codes must hold an active DEX Z-Code before submitting claims.
The claim is denied automatically. There's no manual override at the claims level, which is why Z-Code registration has to happen before billing.
Alaska, Arizona, Idaho, Montana, North Dakota, Oregon, South Dakota, Utah, Washington, and Wyoming.
Quarterly for stable diabetic patients under LCD L35062. More frequent billing needs documentation of a new diagnosis or treatment change.
Noridian's JF contract had the earliest anticipated renewal date among the 12 A/B MAC jurisdictions in TransLabs' prior tracking, with Noridian expected to retain it. Confirm the current award status at cms.gov.
CMS-855B, submitted to Noridian's enrollment unit in Fargo, ND — the same infrastructure used for JE.
