Lucid Diagnostics Launches New Pathways for EsoGuard and EsoCheck Billing and Payment Procedures

Lucid Diagnostics Enhances Payment Pathways for Cancer Prevention Tests

Overview

In a significant leap forward for cancer prevention diagnostics, Lucid Diagnostics Inc. (Nasdaq: LUCD), a subsidiary of PAVmed Inc. (Nasdaq: PAVM), recently announced notable advancements in payment, billing, and coding pathways for its EsoGuard® esophageal DNA test and EsoCheck® esophageal cell collection device. These developments were highlighted following three pivotal public meetings held in mid-September 2026, marking a critical step in facilitating easier access to vital cancer screening tools.

Medicare Advisory Panel Recommendations

During a special meeting convened on September 15-16 by the Centers for Medicare & Medicaid Services (CMS), recommendations were made regarding payment structures for Clinical Diagnostic Laboratory Tests (CDLT). The Advisory Panel suggested preserving the original gapfill payment basis for EsoGuard, referenced by PLA code 0114U. This payment structure, established in the 2021 Clinical Laboratory Fee Schedule (CLFS) update, reflects the ongoing commitment to ensuring that these diagnostic tools remain accessible and affordable for patients.

American Medical Association Approvals

The American Medical Association (AMA) also played a crucial role in these advancements during its September 2026 meeting, where a new Category III CPT code was approved specifically for nonendoscopic esophageal cell collection procedures conducted using EsoCheck. This newly established code will enable healthcare providers to report and track those procedures, enhancing clinical evaluations and ultimately boosting the usage of this innovative technology.

CDC/NCHS Overview of New Diagnosis Codes

Furthering the efforts to improve diagnostic accuracy and patient care, the CDC/NCHS held a meeting where a proposed ICD-10-CM diagnosis code was discussed for reporting positive EsoGuard results. By establishing a unique code for the two methylated DNA biomarkers that EsoGuard tests, this proposal, backed by the American Foregut Society (AFS), aims to facilitate better tracking of clinical outcomes and provide essential data for subsequent confirmatory procedures like upper endoscopies.

The Importance of These Developments

Lishan Aklog, M.D., the Executive Chairman and CEO of Lucid Diagnostics, remarked, "These public meetings mark vital milestones in progressing payment, billing, and coding modalities for EsoGuard esophageal pre-cancer testing." Enhanced payment frameworks are expected to create more commercial opportunities, especially for Medicare beneficiaries, allowing more patients to benefit from these advanced diagnostic methods.

Laboratory and Testing Operations

Lucid Diagnostics operates two CLIA-certified laboratories, positioned in Lake Forest, California, and Irving, Texas. These facilities are designed to conduct EsoGuard testing utilizing samples collected via EsoCheck. The California laboratory will soon begin submitting Medicare claims under the PLA code 0114U, contingent on the finalization of a revised Local Coverage Determination (LCD) tied to Lucid's pending reconsideration request.

Conversely, the facility in Texas, operating under a different MAC jurisdiction, is ready to start processing claims under the same PLA code this month. This strategic approach not only enhances the operational efficiency of Lucid's services but also significantly broadens accessibility for patients requiring these essential diagnostic tests.

Conclusion

The advancements made by Lucid Diagnostics in modifying the payment and coding systems for EsoGuard and EsoCheck illustrate a proactive approach to enhancing healthcare access, particularly for patients at risk of esophageal cancers. These changes hold the promise to enrich diagnostic accuracy and expedite cancer prevention efforts throughout the healthcare system. For further insights into their initiatives and product offerings, visit Lucid's website at www.luciddx.com or learn more about its parent company at www.pavmed.com.

This article reflects Lucid Diagnostics' commitment to advancing medical diagnostics and ensuring that essential health services remain accessible to those in need, while also paving the way for innovative technologies to flourish in the clinical landscape.