Laboratory Management
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There may be instances in which your health plan policies take precedence over the EviCore by Evernorth clinical guidelines. If you have any questions, please reach out to your health plan.
Follow the below steps to access the clinical guidelines.
- Enter your Health Plan name into the search field and click on the magnifying glass.
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Example:
The statement in your letter reads:
We based this decision on the guideline as listed below:
-MTHFR Variant Analysis for Hyperhomocysteinemia (MOL.TX.205).
Enter your Health Plan name into the search field and click on the magnifying glass.
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Code Lists
Guidelines
Code Lists
Guidelines
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Capital Blue Cross Lab Management GuidelinesEffective 01/01/2026 - 06/30/2026
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Capital Blue Cross Lab Management GuidelinesEffective 11/01/2025 - 12/31/2025
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MOL.AD.107.A: Unique Test Identifiers for Non-Specific Procedure CodesEffective 11/01/2025 - 12/31/2025
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MOL.AD.107.A: Unique Test Identifiers for Non-Specific Procedure CodesEffective 01/01/2026 - 06/30/2026
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MOL.AD.304.A: Medical Necessity Review Information RequirementsEffective 11/01/2025 - 12/31/2025
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MOL.AD.304.A: Medical Necessity Review Information RequirementsEffective 01/01/2026 - 06/30/2026
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MOL.AD.314.A: Date of Service and Authorization Period Effective DateEffective 11/01/2025 - 12/31/2025
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MOL.AD.314.A: Date of Service and Authorization Period Effective DateEffective 01/01/2026 - 06/30/2026
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MOL.AD.364.A: Special Circumstances Influencing Coverage DeterminationsEffective 11/01/2025 - 12/31/2025
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MOL.AD.364.A: Special Circumstances Influencing Coverage DeterminationsEffective 01/01/2026 - 06/30/2026
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MOL.AD.411.A: Laboratory Testing Procedure Code RequirementsEffective 01/01/2026 - 06/30/2026
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MOL.AD.411.A: Laboratory Testing Procedure Code RequirementsEffective 11/01/2025 - 12/31/2025
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MOL.AD.412.A: Laboratory Billing and ReimbursementEffective 11/01/2025 - 12/31/2025
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MOL.AD.412.A: Laboratory Billing and ReimbursementEffective 01/01/2026 - 06/30/2026
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MOL.CU.109.A: Genetic Testing for Cancer Susceptibility and Hereditary Cancer SyndromesEffective 11/01/2025 - 12/31/2025
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MOL.CU.109.A: Genetic Testing for Cancer Susceptibility and Hereditary Cancer SyndromesEffective 01/01/2026 - 06/30/2026
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MOL.CU.110.A: Genetic Testing for Carrier StatusEffective 11/01/2025 - 12/31/2025
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MOL.CU.110.A: Genetic Testing for Carrier StatusEffective 01/01/2026 - 06/30/2026
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MOL.CU.111.A: Genetic Testing for Non-Medical PurposesEffective 11/01/2025 - 12/31/2025
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MOL.CU.111.A: Genetic Testing for Non-Medical PurposesEffective 01/01/2026 - 06/30/2026
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MOL.CU.112.A: Genetic Testing for Prenatal Screening and Diagnostic TestingEffective 11/01/2025 - 12/31/2025
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MOL.CU.112.A: Genetic Testing for Prenatal Screening and Diagnostic TestingEffective 01/01/2026 - 06/30/2026
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MOL.CU.113.A: Genetic Testing for the Screening, Diagnosis, and Monitoring of CancerEffective 11/01/2025 - 12/31/2025
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MOL.CU.113.A: Genetic Testing for the Screening, Diagnosis, and Monitoring of CancerEffective 01/01/2026 - 06/30/2026
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MOL.CU.114.A: Genetic Testing to Diagnose Non-Cancer ConditionsEffective 11/01/2025 - 12/31/2025
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MOL.CU.114.A: Genetic Testing to Diagnose Non-Cancer ConditionsEffective 01/01/2026 - 06/30/2026
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MOL.CU.115.A: Genetic Testing to Predict Disease RiskEffective 11/01/2025 - 12/31/2025
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MOL.CU.115.A: Genetic Testing to Predict Disease RiskEffective 01/01/2026 - 06/30/2026
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MOL.CU.116.A: Genetic Testing by Multigene PanelsEffective 11/01/2025 - 12/31/2025
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MOL.CU.116.A: Genetic Testing by Multigene PanelsEffective 01/01/2026 - 06/30/2026
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MOL.CU.117.A: Experimental, Investigational, or Unproven Laboratory TestingEffective 11/01/2025 - 12/31/2025
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MOL.CU.117.A: Experimental, Investigational, or Unproven Laboratory TestingEffective 01/01/2026 - 06/30/2026
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MOL.CU.118.A: Pharmacogenomic Testing for Drug Toxicity and ResponseEffective 11/01/2025 - 12/31/2025
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MOL.CU.118.A: Pharmacogenomic Testing for Drug Toxicity and ResponseEffective 01/01/2026 - 06/30/2026
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MOL.CU.119.A: Preimplantation Genetic Screening and DiagnosisEffective 11/01/2025 - 12/31/2025
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MOL.CU.119.A: Preimplantation Genetic Screening and DiagnosisEffective 01/01/2026 - 06/30/2026
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MOL.CU.246.A: Hereditary (Germline) Testing After Tumor (Somatic) TestingEffective 11/01/2025 - 12/31/2025
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MOL.CU.246.A: Hereditary (Germline) Testing After Tumor (Somatic) TestingEffective 01/01/2026 - 06/30/2026
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MOL.CU.256.A: Confirmatory Genetic TestingEffective 11/01/2025 - 12/31/2025
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MOL.CU.256.A: Confirmatory Genetic TestingEffective 01/01/2026 - 06/30/2026
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MOL.CU.291.A: Genetic Testing for Known Familial MutationsEffective 11/01/2025 - 12/31/2025
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MOL.CU.291.A: Genetic Testing for Known Familial MutationsEffective 01/01/2026 - 06/30/2026
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MOL.CU.292.A: Genetic Testing for Variants of Uncertain Clinical SignificanceEffective 11/01/2025 - 12/31/2025
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MOL.CU.292.A: Genetic Testing for Variants of Uncertain Clinical SignificanceEffective 01/01/2026 - 06/30/2026
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MOL.CU.333.B: Medically Necessary Laboratory TestingEffective 11/01/2025 - 12/31/2025
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MOL.CU.333.B: Medically Necessary Laboratory TestingEffective 01/01/2026 - 06/30/2026
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MOL.TS.120.A: 4Kscore for Prostate Cancer Risk AssessmentEffective 11/01/2025 - 12/31/2025
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MOL.TS.120.A: 4Kscore for Prostate Cancer Risk AssessmentEffective 01/01/2026 - 06/30/2026
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MOL.TS.122.A: Afirma Thyroid Cancer Classifier TestsEffective 11/01/2025 - 12/31/2025
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MOL.TS.122.A: Afirma Thyroid Cancer Classifier TestsEffective 01/01/2026 - 06/30/2026
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MOL.TS.123.A: AlloMap Gene Expression Profiling For Heart Transplant RejectionEffective 11/01/2025 - 12/31/2025
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MOL.TS.123.A: AlloMap Gene Expression Profiling For Heart Transplant RejectionEffective 01/01/2026 - 06/30/2026
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MOL.TS.124.A: Alpha-1 Antitrypsin Deficiency TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.124.A: Alpha-1 Antitrypsin Deficiency TestingEffective 01/01/2026 - 06/30/2026
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MOL.TS.125.A: Amyotrophic Lateral Sclerosis (ALS) Genetic TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.125.A: Amyotrophic Lateral Sclerosis (ALS) Genetic TestingEffective 01/01/2026 - 06/30/2026
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MOL.TS.126.A: Angelman Syndrome Genetic TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.126.A: Angelman Syndrome Genetic TestingEffective 01/01/2026 - 06/30/2026
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MOL.TS.128.A: APOE Variant Analysis for Alzheimer Disease TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.128.A: APOE Variant Analysis for Alzheimer Disease TestingEffective 01/01/2026 - 06/30/2026
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MOL.TS.129.A: Ashkenazi Jewish Carrier ScreeningEffective 11/01/2025 - 12/31/2025
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MOL.TS.129.A: Ashkenazi Jewish Carrier ScreeningEffective 01/01/2026 - 06/30/2026
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MOL.TS.130.A: Ataxia-Telangiectasia Genetic TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.144.A: CADASIL Genetic TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.144.A: CADASIL Genetic TestingEffective 01/01/2026 - 06/30/2026
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MOL.TS.148.A: Charcot-Marie-Tooth Neuropathy Genetic TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.148.A: Charcot-Marie-Tooth Neuropathy Genetic TestingEffective 01/01/2026 - 06/30/2026
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MOL.TS.150.A: Chromosomal Microarray Testing for Developmental Disorders (Prenatal and Postnatal)Effective 11/01/2025 - 12/31/2025
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MOL.TS.150.A: Chromosomal Microarray Testing For Developmental Disorders (Prenatal and Postnatal)Effective 01/01/2026 - 06/30/2026
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MOL.TS.151.A: Chromosome Analysis for Blood and Bone Marrow CancersEffective 11/01/2025 - 12/31/2025
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MOL.TS.151.A: Chromosome Analysis for Blood and Bone Marrow CancersEffective 01/01/2026 - 06/30/2026
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MOL.TS.152.A: Cologuard Screening for Colorectal CancerEffective 11/01/2025 - 12/31/2025
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MOL.TS.152.A: Cologuard Screening for Colorectal CancerEffective 01/01/2026 - 06/30/2026
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MOL.TS.153.A: ConfirmMDx for Prostate Cancer Risk AssessmentEffective 11/01/2025 - 12/31/2025
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MOL.TS.153.A: ConfirmMDx for Prostate Cancer Risk AssessmentEffective 01/01/2026 - 06/30/2026
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MOL.TS.158.A: Cystic Fibrosis Genetic TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.158.A: Cystic Fibrosis Genetic TestingEffective 01/01/2026 - 06/30/2026
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MOL.TS.159.A: Dentatorubral-Pallidoluysian Atrophy Genetic TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.161.A: Duchenne and Becker Muscular Dystrophy TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.161.A: Duchenne and Becker Muscular Dystrophy TestingEffective 01/01/2026 - 06/30/2026
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MOL.TS.162.A: Early Onset Familial Alzheimer Disease Genetic TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.162.A: Early Onset Familial Alzheimer Disease Genetic TestingEffective 01/01/2026 - 06/30/2026
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MOL.TS.164.A: SEPT9 Methylation Analysis for Colorectal CancerEffective 11/01/2025 - 12/31/2025
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MOL.TS.164.A: SEPT9 Methylation Analysis for Colorectal CancerEffective 01/01/2026 - 06/30/2026
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MOL.TS.165.A: Carrier Screening Panels, Including Targeted, Pan-Ethnic, Universal, and ExpandedEffective 11/01/2025 - 12/31/2025
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MOL.TS.165.A: Carrier Screening Panels, Including Targeted, Pan-Ethnic, Universal, and ExpandedEffective 01/01/2026 - 06/30/2026
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MOL.TS.168.A: Familial Adenomatous Polyposis Genetic TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.168.A: Familial Adenomatous Polyposis Genetic TestingEffective 01/01/2026 - 06/30/2026
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MOL.TS.169.A: Familial Hypercholesterolemia Genetic TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.169.A: Familial Hypercholesterolemia Genetic TestingEffective 01/01/2026 - 06/30/2026
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MOL.TS.170.A: Familial Malignant Melanoma Genetic TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.170.A: Familial Malignant Melanoma Genetic TestingEffective 01/01/2026 - 06/30/2026
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MOL.TS.172.A: FMR1-Related Disorders (Fragile X) Genetic TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.172.A: FMR1-Related Disorders (Fragile X) Genetic TestingEffective 01/01/2026 - 06/30/2026
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MOL.TS.182.A: Hereditary Cancer Syndrome Multigene PanelsEffective 11/01/2025 - 12/31/2025
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MOL.TS.182.A: Hereditary Cancer Syndrome Multigene PanelsEffective 01/01/2026 - 06/30/2026
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MOL.TS.183.A: HFE Hemochromatosis Genetic TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.183.A: HFE Hemochromatosis Genetic TestingEffective 01/01/2026 - 06/30/2026
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MOL.TS.188.A: Huntington Disease Genetic TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.188.A: Huntington Disease Genetic TestingEffective 01/01/2026 - 06/30/2026
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MOL.TS.193.A: Li-Fraumeni Syndrome Genetic TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.193.A: Li-Fraumeni Syndrome Genetic TestingEffective 01/01/2026 - 06/30/2026
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MOL.TS.194.A: Liquid Biopsy TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.194.A: Liquid Biopsy TestingEffective 01/01/2026 - 06/30/2026
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MOL.TS.197.A: Lynch Syndrome Genetic TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.197.A: Lynch Syndrome Genetic TestingEffective 01/01/2026 - 06/30/2026
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MOL.TS.199.A: Lynch Syndrome Tumor Screening - Second TierEffective 11/01/2025 - 12/31/2025
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MOL.TS.199.A: Lynch Syndrome Tumor Screening - Second-TierEffective 01/01/2026 - 06/30/2026
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MOL.TS.200.A: Mammaprint 70-Gene Breast Cancer Recurrence AssayEffective 11/01/2025 - 12/31/2025
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MOL.TS.200.A: Mammaprint 70-Gene Breast Cancer Recurrence AssayEffective 01/01/2026 - 06/30/2026
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MOL.TS.202.A: Marfan Syndrome Genetic TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.206.A: MUTYH Associated Polyposis Genetic TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.206.A: MUTYH Associated Polyposis Genetic TestingEffective 01/01/2026 - 06/30/2026
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MOL.TS.209.A: Non-Invasive Prenatal ScreeningEffective 11/01/2025 - 12/31/2025
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MOL.TS.209.A: Non-Invasive Prenatal ScreeningEffective 01/01/2026 - 06/30/2026
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MOL.TS.211.A: Oncotype DX for Breast Cancer PrognosisEffective 11/01/2025 - 12/31/2025
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MOL.TS.211.A: Oncotype DX for Breast Cancer PrognosisEffective 01/01/2026 - 06/30/2026
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MOL.TS.213.A: Oncotype DX for Colorectal Cancer Recurrence RiskEffective 11/01/2025 - 12/31/2025
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MOL.TS.213.A: Oncotype DX for Colorectal Cancer Recurrence RiskEffective 01/01/2026 - 06/30/2026
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MOL.TS.215.A: PCA3 Testing for Prostate CancerEffective 11/01/2025 - 12/31/2025
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MOL.TS.215.A: PCA3 Testing for Prostate CancerEffective 01/01/2026 - 06/30/2026
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MOL.TS.216.A: Peutz-Jeghers Syndrome Genetic TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.216.A: Peutz-Jeghers Syndrome Genetic TestingEffective 01/01/2026 - 06/30/2026
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MOL.TS.217.A: Prader-Willi Syndrome Genetic TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.217.A: Prader-Willi Syndrome Genetic TestingEffective 01/01/2026 - 06/30/2026
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MOL.TS.220.A: Prenatal Maternal Serum ScreeningEffective 11/01/2025 - 12/31/2025
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MOL.TS.220.A: Prenatal Maternal Serum ScreeningEffective 01/01/2026 - 06/30/2026
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MOL.TS.222.A: Prosigna Breast Cancer Prognostic Gene Signature AssayEffective 11/01/2025 - 12/31/2025
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MOL.TS.222.A: Prosigna Breast Cancer Prognostic Gene Signature AssayEffective 01/01/2026 - 06/30/2026
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MOL.TS.223.A: PTEN Hamartoma Tumor Syndromes Genetic TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.223.A: PTEN Hamartoma Tumor Syndromes Genetic TestingEffective 01/01/2026 - 06/30/2026
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MOL.TS.224.A: Rett Syndrome Genetic TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.224.A: Rett Syndrome Genetic TestingEffective 01/01/2026 - 06/30/2026
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MOL.TS.225.A: Spinal Muscular Atrophy Genetic TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.225.A: Spinal Muscular Atrophy Genetic TestingEffective 01/01/2026 - 06/30/2026
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MOL.TS.227.A: Thoracic Aortic Aneurysms and Dissections (TAAD) Panel Genetic TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.228.A: Tissue of Origin Testing for Cancer of Unknown PrimaryEffective 11/01/2025 - 12/31/2025
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MOL.TS.228.A: Tissue of Origin Testing for Cancer of Unknown PrimaryEffective 01/01/2026 - 06/30/2026
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MOL.TS.230.A: Somatic Mutation TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.230.A: Somatic Mutation TestingEffective 01/01/2026 - 06/30/2026
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MOL.TS.232.A: VeriStrat Testing for NSCLC TKI ResponseEffective 11/01/2025 - 12/31/2025
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MOL.TS.233.A: Von Hippel-Lindau Disease Genetic TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.233.A: Von Hippel-Lindau Disease Genetic TestingEffective 01/01/2026 - 06/30/2026
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MOL.TS.234.A: EndoPredict for Breast Cancer PrognosisEffective 11/01/2025 - 12/31/2025
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MOL.TS.234.A: EndoPredict for Breast Cancer PrognosisEffective 01/01/2026 - 06/30/2026
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MOL.TS.235.A: Exome SequencingEffective 11/01/2025 - 12/31/2025
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MOL.TS.235.A: Exome SequencingEffective 01/01/2026 - 06/30/2026
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MOL.TS.236.A: CxbladderEffective 11/01/2025 - 12/31/2025
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MOL.TS.236.A: CxbladderEffective 01/01/2026 - 06/30/2026
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MOL.TS.238.A: BRCA AnalysisEffective 11/01/2025 - 12/31/2025
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MOL.TS.238.A: BRCA AnalysisEffective 01/01/2026 - 06/30/2026
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MOL.TS.240.A: BCR-ABL Negative Myeloproliferative Neoplasm Genetic TestingEffective 01/01/2026 - 06/30/2026
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MOL.TS.240.A: BCR-ABL Negative Myeloproliferative Neoplasm TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.248.A: Breast Cancer Index for Breast Cancer PrognosisEffective 11/01/2025 - 12/31/2025
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MOL.TS.248.A: Breast Cancer Index for Breast Cancer PrognosisEffective 01/01/2026 - 06/30/2026
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MOL.TS.250.A: NETestEffective 11/01/2025 - 12/31/2025
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MOL.TS.250.A: NETestEffective 01/01/2026 - 06/30/2026
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MOL.TS.251.A: PALB2 Genetic Testing for Cancer RiskEffective 11/01/2025 - 12/31/2025
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MOL.TS.251.A: PALB2 Genetic Testing for Cancer RiskEffective 01/01/2026 - 06/30/2026
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MOL.TS.254.A: DecisionDX Uveal MelanomaEffective 11/01/2025 - 12/31/2025
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MOL.TS.254.A: DecisionDX Uveal MelanomaEffective 01/01/2026 - 06/30/2026
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MOL.TS.255.A: Oncotype DX Breast DCISEffective 11/01/2025 - 12/31/2025
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MOL.TS.255.A: Oncotype DX Breast DCISEffective 01/01/2026 - 06/30/2026
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MOL.TS.257.A: Epilepsy Genetic TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.257.A: Epilepsy Genetic TestingEffective 01/01/2026 - 06/30/2026
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MOL.TS.258.A: Maturity-Onset Diabetes of the Young (MODY) Genetic TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.258.A: Maturity-Onset Diabetes of the Young Genetic TestingEffective 01/01/2026 - 06/30/2026
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MOL.TS.259.A: ThyGeNEXT and ThyraMIR miRNA Gene Expression ClassifierEffective 11/01/2025 - 12/31/2025
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MOL.TS.259.A: ThyGeNEXT and ThyraMIR miRNA Gene Expression ClassifierEffective 01/01/2026 - 06/30/2026
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MOL.TS.260.A: OVA1Effective 11/01/2025 - 12/31/2025
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MOL.TS.264.A: Select mdxEffective 11/01/2025 - 12/31/2025
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MOL.TS.264.A: SelectMDxEffective 01/01/2026 - 06/30/2026
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MOL.TS.266.A: Mitochondrial Disorders Genetic TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.266.A: Mitochondrial Disorders Genetic TestingEffective 01/01/2026 - 06/30/2026
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MOL.TS.267.A: Ehlers-Danlos Syndrome Genetic TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.268.A: Hereditary Connective Tissue Disorder Genetic TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.269.A: Autism, Intellectual Disability, and Developmental Delay Genetic TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.269.A: Autism, Intellectual Disability, and Developmental Delay Genetic TestingEffective 01/01/2026 - 06/30/2026
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MOL.TS.270.A: ThyroseqEffective 11/01/2025 - 12/31/2025
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MOL.TS.270.A: ThyroseqEffective 01/01/2026 - 06/30/2026
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MOL.TS.271.A: PancraGENEffective 11/01/2025 - 12/31/2025
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MOL.TS.273.A Nonsyndromic Hearing Loss and Deafness Genetic TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.273.A: Nonsyndromic Hearing Loss and Deafness Genetic TestingEffective 01/01/2026 - 06/30/2026
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MOL.TS.276.A: Polymerase Gamma (POLG) Related Disorders Genetic TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.276.A: Polymerase Gamma (POLG) Related Disorders Genetic TestingEffective 01/01/2026 - 06/30/2026
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MOL.TS.282.A: DermTech Melanoma TestEffective 01/01/2026 - 06/30/2026
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MOL.TS.282.A: DermTech Pigmented Lesion AssayEffective 11/01/2025 - 12/31/2025
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MOL.TS.285.A: Multiple Endocrine Neoplasia Type 1 Genetic TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.285.A: Multiple Endocrine Neoplasia Type 1 Genetic TestingEffective 01/01/2026 - 06/30/2026
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MOL.TS.286.A: Multiple Endocrine Neoplasia Type 2 Genetic TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.286.A: Multiple Endocrine Neoplasia Type 2 Genetic TestingEffective 01/01/2026 - 06/30/2026
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MOL.TS.287.A: Hereditary Pancreatitis Genetic TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.287.A: Hereditary Pancreatitis Genetic TestingEffective 01/01/2026 - 06/30/2026
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MOL.TS.288.A: Limb-Girdle Muscular Dystrophy Genetic TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.288.A: Limb-Girdle Muscular Dystrophy Genetic TestingEffective 01/01/2026 - 06/30/2026
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MOL.TS.290.A: Facioscapulohumeral Muscular Dystrophy Genetic TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.290.A: Facioscapulohumeral Muscular Dystrophy Genetic TestingEffective 01/01/2026 - 06/30/2026
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MOL.TS.294.A: Decipher Prostate Cancer ClassifierEffective 11/01/2025 - 12/31/2025
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MOL.TS.294.A: Decipher Prostate Cancer ClassifierEffective 01/01/2026 - 06/30/2026
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MOL.TS.295.A: Genomic Prostate ScoreEffective 11/01/2025 - 12/31/2025
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MOL.TS.295.A: Genomic Prostate ScoreEffective 01/01/2026 - 06/30/2026
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MOL.TS.297.A: ProlarisEffective 11/01/2025 - 12/31/2025
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MOL.TS.297.A: ProlarisEffective 01/01/2026 - 06/30/2026
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MOL.TS.301.A: Neurofibromatosis Type 1 Genetic TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.301.A: Neurofibromatosis Type 1 Genetic TestingEffective 01/01/2026 - 06/30/2026
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MOL.TS.302.A: Legius Syndrome Genetic TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.302.A: Legius Syndrome Genetic TestingEffective 01/01/2026 - 06/30/2026
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MOL.TS.306.A: Genome SequencingEffective 11/01/2025 - 12/31/2025
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MOL.TS.306.A: Genome SequencingEffective 01/01/2026 - 06/30/2026
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MOL.TS.307.A: AlloSure for Kidney Transplant RejectionEffective 11/01/2025 - 12/31/2025
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MOL.TS.307.A: AlloSure for Kidney Transplant RejectionEffective 01/01/2026 - 06/30/2026
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MOL.TS.308.A: Hemoglobinopathies Genetic TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.308.A: Hemoglobinopathies Genetic TestingEffective 01/01/2026 - 06/30/2026
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MOL.TS.309.A: Friedreich Ataxia Genetic TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.310.A: Hereditary Ataxia Multigene Panel TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.311.A: Spinocerebellar Ataxia Genetic TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.312.A: Myotonic Dystrophy Type 1 Genetic TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.312.A: Myotonic Dystrophy Type 1 Genetic TestingEffective 01/01/2026 - 06/30/2026
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MOL.TS.324.A: CHARGE Syndrome and CHD7 Disorder Genetic TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.324.A: CHARGE Syndrome and CHD7 Disorder Genetic TestingEffective 01/01/2026 - 06/30/2026
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MOL.TS.344.A: Chromosomal Microarray for Solid TumorsEffective 11/01/2025 - 12/31/2025
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MOL.TS.344.A: Chromosomal Microarray for Solid TumorsEffective 01/01/2026 - 06/30/2026
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MOL.TS.356.A: Microsatellite Instability and Immunohistochemistry Testing in CancerEffective 11/01/2025 - 12/31/2025
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MOL.TS.356.A: Microsatellite Instability and Immunohistochemistry Testing in CancerEffective 01/01/2026 - 06/30/2026
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MOL.TS.359.A: Inflammatory Bowel Disease Biomarker TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.359.A: Inflammatory Bowel Disease Biomarker TestingEffective 01/01/2026 - 06/30/2026
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MOL.TS.360.A: Inherited Bone Marrow Failure Syndrome (IBMFS) TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.360.A: Inherited Bone Marrow Failure Syndrome (IBMFS) TestingEffective 01/01/2026 - 06/30/2026
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MOL.TS.361.A: Human Platelet and Red Blood Cell Antigen GenotypingEffective 11/01/2025 - 12/31/2025
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MOL.TS.361.A: Human Platelet and Red Blood Cell Antigen GenotypingEffective 01/01/2026 - 06/30/2026
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MOL.TS.366.A: OvaSuiteEffective 01/01/2026 - 06/30/2026
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MOL.TS.370.A: Inherited Thrombophilia Genetic TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.370.A: Inherited Thrombophilia Genetic TestingEffective 01/01/2026 - 06/30/2026
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MOL.TS.371.A: Noonan Spectrum Disorder Genetic TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.371.A: Noonan Spectrum Disorder Genetic TestingEffective 01/01/2026 - 06/30/2026
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MOL.TS.396.A: Multi-Cancer Early Detection ScreeningEffective 11/01/2025 - 12/31/2025
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MOL.TS.396.A: Multi-Cancer Early Detection ScreeningEffective 01/01/2026 - 06/30/2026
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MOL.TS.401.A: Liver Fibrosis Assessment BiomarkersEffective 11/01/2025 - 12/31/2025
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MOL.TS.401.A: Liver Fibrosis Assessment BiomarkersEffective 01/01/2026 - 06/30/2026
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MOL.TS.410.A: Cardiomyopathy and Arrhythmia Genetic TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.410.A: Cardiomyopathy and Arrhythmia Genetic TestingEffective 01/01/2026 - 06/30/2026
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MOL.TS.413.A: ColoSense for Colorectal CancerEffective 11/01/2025 - 12/31/2025
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MOL.TS.413.A: ColoSense for Colorectal CancerEffective 01/01/2026 - 06/30/2026
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MOL.TS.419.A: Primary Ciliary Dyskinesia Genetic TestingEffective 11/01/2025 - 12/31/2025
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MOL.TS.419.A: Primary Ciliary Dyskinesia Genetic TestingEffective 01/01/2026 - 06/30/2026
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MOL.TS.425.A: Hereditary Ataxia Genetic TestingEffective 01/01/2026 - 06/30/2026
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MOL.TS.427.A: Hereditary Connective Tissue and Thoracic Aortic Disease Genetic TestingEffective 01/01/2026 - 06/30/2026