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MOL.AD.102.A: Molecular Pathology Tier 2 Molecular CPT Codes
Effective 07/01/2022
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MOL.AD.107.A: Unique Test Identifiers for Non Specific Procedure Codes
Effective 07/01/2022
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MOL.AD.304.A: Medical Necessity Review Information Requirements
Effective 07/01/2022
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MOL.AD.314.A: Date of Service and Authorization Period Effective Date
Effective 07/01/2022
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MOL.AD.364.A: Special Circumstances Influencing Coverage Determinations
Effective 07/01/2022
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MOL.CU.109.A: Genetic Testing for Cancer Susceptibility and Hereditary Cancer Syndromes
Effective 07/01/2022
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MOL.CU.110.A: Genetic Testing for Carrier Status
Effective 07/01/2022
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MOL.CU.111.A: Genetic Testing for Non Medical Purposes
Effective 07/01/2022
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MOL.CU.112.A: Genetic Testing for Prenatal Screening and Diagnostic Testing
Effective 07/01/2022
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MOL.CU.113.A: Genetic Testing for the Screening, Diagnosis, and Monitoring of Cancer
Effective 07/01/2022
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MOL.CU.114.A: Genetic Testing to Diagnose Non Cancer Conditions
Effective 07/01/2022
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MOL.CU.115.A: Genetic Testing to Predict Disease Risk
Effective 07/01/2022
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MOL.CU.116.A: Genetic Testing by Multigene Panels
Effective 07/01/2022
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MOL.CU.117.A Investigational and Experimental Molecular and Genomic Testing
Effective 07/01/2022
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MOL.CU.118.A: Pharmacogenomic Testing for Drug Toxicity and Response
Effective 07/01/2022
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MOL.CU.119.B: Preimplantation Genetic Screening and Diagnosis
Effective 07/01/2022
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MOL.CU.246.A: Hereditary (Germline) Testing After Tumor (Somatic) Testing
Effective 07/01/2022
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MOL.CU.256.A: Confirmatory Genetic Testing
Effective 07/01/2022
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MOL.CU.291.A: Genetic Testing for Known Familial Mutations
Effective 07/01/2022
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MOL.CU.292.A: Genetic Testing for Variants of Uncertain Clinical Significance
Effective 07/01/2022
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MOL.CU.298.A: Genetic Presymptomatic and Predictive Testing for Adult Onset Conditions in Minors
Effective 07/01/2022
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MOL.CS.185.A: HIV Tropism Testing for Maraviroc Response
Effective 07/01/2022
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MOL.CS.333.A: Medically Necessary Laboratory Testing
Effective 07/01/2022
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MOL.TS.370.A: Inherited Thrombophilia Genetic Testing
Effective 07/01/2022
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MOL.TS.371.A: Noonan Spectrum Disorder Genetic Testing
Effective 07/01/2022
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MOL.CS.103.A: Flow Cytometry
Effective 07/01/2022
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MOL.CS.104.A: Immunohistochemistry
Effective 07/01/2022
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MOL.CS.105.A: Laboratory Claim Reimbursement
Effective 07/01/2022
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MOL.CS.106.A: Genitourinary Conditions Molecular Testing
Effective 07/01/2022
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MOL.CS.108.A: UroVysion FISH for Bladder Cancer
Effective 07/01/2022
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MOL.CS.146.A: HLA Typing for Celiac Disease
Effective 07/01/2022
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MOL.CS.218.A: Prenatal Aneuploidy FISH Testing
Effective 07/01/2022
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MOL.CS.277.A: Molecular Gastrointestinal Pathogen Panel (GIPP) Testing
Effective 07/01/2022
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MOL.CS.289.A: Chromosome Analysis for Reproductive Disorders, Prenatal-Testing, and Developmental Disorders
Effective 07/01/2022
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MOL.CS.293.A: Molecular Respiratory Infection Pathogen Panel (RIPP) Testing
Effective 07/01/2022
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MOL.CS.321.A: In-vitro Testing for HIV
Effective 07/01/2022
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MOL.CS.332.A: Lyme Disease Testing
Effective 07/01/2022
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MOL.CS.362.A: Human Papillomavirus (HPV) Molecular Testing
Effective 07/01/2022
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MOL.CS.363.A: Pathology Testing with Mohs Micrographic Surgery
Effective 07/01/2022
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MOL.CS.353.A: In-vitro testing for SARS CoV-2 (COVID 19)
Effective 07/01/2022
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MOL.TS.120.A: 4Kscore for Prostate Cancer Risk Assessment
Effective 07/01/2022
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MOL.TS.123.A: AlloMap Gene Expression Profiling for Heart Transplant Rejection
Effective 07/01/2022
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MOL.TS.124.A: Alpha 1 Antitrypsin Deficiency Testing
Effective 07/01/2022
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MOL.TS.125.A: Amyotrophic Lateral Sclerosis (ALS) Genetic Testing
Effective 07/01/2022
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MOL.TS.126.A: Angelman Syndrome Testing
Effective 07/01/2022
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MOL.TS.128.A: APOE Variant Analysis for Alzheimer Disease Testing
Effective 07/01/2022
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MOL.TS.129.A: Ashkenazi Jewish Carrier Screening
Effective 07/01/2022
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MOL.TS.130.A: Ataxia Telangiectasia Testing
Effective 07/01/2022
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MOL.TS.132.A: Bloom Syndrome Testing
Effective 07/01/2022
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MOL.TS.135.A: BRCA Ashkenazi Jewish Founder Mutation Testing
Effective 07/01/2022
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MOL.TS.144.A: CADASIL Testing
Effective 07/01/2022
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MOL.TS.145.A: Canavan Disease Testing
Effective 07/01/2022
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MOL.TS.148.A: Charcot-Marie-Tooth Neuropathy Testing
Effective 07/01/2022
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MOL.TS.149.A: Chromosomal Microarray for Prenatal Diagnosis
Effective 07/01/2022
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MOL.TS.150.A: Chromosomal Microarray Testing For Developmental Disorders
Effective 07/01/2022
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MOL.TS.151.A: Chromosome Analysis for Blood and Bone Marrow Cancers
Effective 07/01/2022
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MOL.TS.152.A: Cologuard Screening for Colorectal Cancer
Effective 07/01/2022
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MOL.TS.153.A: ConfirmMDx for Prostate Cancer Risk Assessment
Effective 07/01/2022
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MOL.TS.158.A: Cystic Fibrosis Testing
Effective 07/01/2022
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MOL.TS.159.A: Dentatorubral Pallidoluysian Atrophy Testing
Effective 07/01/2022
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MOL.TS.161.A: Duchenne and Becker Muscular Dystrophy Testing
Effective 07/01/2022
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MOL.TS.162A: Early Onset Familial Alzheimer Disease (EOFAD) Genetic Testing
Effective 07/01/2022
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MOL.TS.164.A: SEPT9 Methylation Analysis for Colorectal Cancer
Effective 07/01/2022
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MOL.TS.165.A: Expanded Carrier Screening Panels
Effective 07/01/2022
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MOL.TS.168.A: Familial Adenomatous Polyposis
Effective 07/01/2022
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MOL.TS.169.A: Familial Hypercholesterolemia Genetic Testing
Effective 07/01/2022
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MOL.TS.170.A: Familial Malignant Melanoma Testing
Effective 07/01/2022
-
MOL.TS.172.A: FMR1 Related Disorders (Fragile X) Genetic Testing
Effective 07/01/2022
-
MOL.TS.173.A: Gaucher Disease Testing
Effective 07/01/2022
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MOL.TS.182.A: Hereditary Cancer Syndrome Multigene Panels
Effective 07/01/2022
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MOL.TS.183.A: Hemochromatosis Testing
Effective 07/01/2022
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MOL.TS.188.A: Huntington Disease
Effective 07/01/2022
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MOL.TS.189.A: Hypertrophic Cardiomyopathy Testing
Effective 07/01/2022
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MOL.TS.193.A: Li Fraumeni Syndrome
Effective 07/01/2022
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MOL.TS.194.A: Liquid Biopsy Testing
Effective 07/01/2022
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MOL.TS.196.A: Long QT Syndrome Testing
Effective 07/01/2022
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MOL.TS.197.A: Lynch Syndrome Genetic Testing
Effective 07/01/2022
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MOL.TS.199.A: Lynch Syndrome Tumor Screening - Second Tier
Effective 07/01/2022
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MOL.TS.200.A: Mammaprint 70-Gene Breast Cancer Recurrence Assay
Effective 07/01/2022
-
MOL.TS.202.A: Marfan Syndrome Genetic Testing
Effective 07/01/2022
-
MOL.TS.206.A: MUTYH Associated Polyposis Testing
Effective 07/01/2022
-
MOL.TS.207.A: Niemann-Pick Disease Types A and B Testing
Effective 07/01/2022
-
MOL.TS.208 A: Niemann-Pick Type C Testing
Effective 07/01/2022
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MOL.TS.209.A: Non-Invasive Prenatal Screening
Effective 07/01/2022
-
MOL.TS.211.A: Oncotype DX for Breast Cancer Prognosis
Effective 07/01/2022
-
MOL.TS.213.A: Oncotype DX for Colorectal Cancer Recurrence Risk
Effective 07/01/2022
-
MOL.TS.215.A: PCA3 Testing for Prostate Cancer
Effective 07/01/2022
-
MOL.TS.216.A: Peutz-Jeghers Syndrome Testing
Effective 07/01/2022
-
MOL.TS.217.A: Prader-Willi Syndrome Testing
Effective 07/01/2022
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MOL.TS.220.A: Prenatal Maternal Serum Screening
Effective 07/01/2022
-
MOL.TS.222.A: Prosigna Breast Cancer Prognostic Gene Signature Assay
Effective 07/01/2022
-
MOL.TS.223.A: PTEN Hamartoma Tumor Syndromes Testing
Effective 07/01/2022
-
MOL.TS.224.A: Rett Syndrome Testing
Effective 07/01/2022
-
MOL.TS.225.A: Spinal Muscular Atrophy Testing
Effective 07/01/2022
-
MOL.TS.226.A: Tay Sachs Disease Testing
Effective 07/01/2022
-
MOL.TS.227.A: Thoracic Aortic Aneurysms and Dissections TAAD Panel Testing
Effective 07/01/2022
-
MOL.TS.228.A: Tissue of Origin Testing for Cancer of Unknown Primary
Effective 07/01/2022
-
MOL.TS.230.A: Somatic Mutation Testing-Solid Tumors
Effective 07/01/2022
-
MOL.TS.232.A: VeriStrat Testing for NSCLC TKI Response
Effective 07/01/2022
-
MOL.TS.232.A: VeriStrat Testing for NSCLC TKI Response
Effective 07/01/2022
-
MOL.TS.233.A: Von Hippel Lindau Disease Testing
Effective 07/01/2022
-
MOL.TS.234.A: EndoPredict for Breast Cancer Prognosis
Effective 07/01/2022
-
MOL.TS.235.A: Exome Sequencing
Effective 07/01/2022
-
MOL.TS.236.A: Cxbladder
Effective 07/01/2022
-
MOL.TS.238.A: BRCA Analysis
Effective 07/01/2022
-
MOL.TS.240.A: BCR ABL Negative Myeloproliferative Neoplasm Testing
Effective 07/01/2022
-
MOL.TS.248.A: Breast Cancer Index for Breast Cancer Prognosis
Effective 07/01/2022
-
MOL.TS.250.A: NETest
Effective 07/01/2022
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MOL.TS.251.A: PALB2 Genetic Testing for Breast Cancer Risk
Effective 07/01/2022
-
MOL.TS.254.A: DecisionDx Uveal Melanoma
Effective 07/01/2022
-
MOL.TS.255.A: Oncotype DX Breast DCIS
Effective 07/01/2022
-
MOL.TS.257.A: Genetic Testing for Epilepsy
Effective 07/01/2022
-
MOL.TS.258.A: Maturity Onset Diabetes of the Young (MODY) Testing
Effective 07/01/2022
-
MOL.TS.259.A: ThyGeNEXT and ThyraMIR miRNA Gene Expression Classifier
Effective 07/01/2022
-
MOL.TS.260.A: OVA1
Effective 07/01/2022
-
MOL.TS.261.A: Brugada Syndrome Genetic Testing
Effective 07/01/2022
-
MOL.TS.262.A: FibroTest FibroSURE
Effective 07/01/2022
-
MOL.TS.264.A: SelectMDx
Effective 07/01/2022
-
MOL.TS.266.A: Mitochondrial Disorders Genetic Testing
Effective 07/01/2022
-
MOL.TS.267.A: Ehlers Danlos Syndrome Testing
Effective 07/01/2022
-
MOL.TS.268.A: Hereditary Connective Tissue Disorder Testing
Effective 07/01/2022
-
MOL.TS.269.A: Genetic Testing for Autism, Intellectual Disability, and Developmental Delay
Effective 07/01/2022
-
MOL.TS.270.A: ThyroSeq
Effective 07/01/2022
-
MOL.TS.271.A: PancraGEN
Effective 07/01/2022
-
MOL.TS.273.A: Genetic Testing for Nonsyndromic Hearing Loss and Deafness
Effective 07/01/2022
-
MOL.TS.276.A: Polymerase Gamma (POLG) Related Disorders Genetic Testing
Effective 07/01/2022
-
MOL.TS.281.A: Genetic Testing for Arrhythmogenic Right Ventricular Cardiomyopathy
Effective 07/01/2022
-
MOL.TS.282.A: DermTech Pigmented Lesion Assay
Effective 07/01/2022
-
MOL.TS.284.A: Genetic Testing for Dilated Cardiomyopathy
Effective 07/01/2022
-
MOL.TS.285.A: Multiple Endocrine Neoplasia Type 1 (MEN1)
Effective 07/01/2022
-
MOL.TS.286.A: Multiple Endocrine Neoplasia Type 2 (MEN2)
Effective 07/01/2022
-
MOL.TS.287.A: Genetic Testing for Hereditary Pancreatitis
Effective 07/01/2022
-
MOL.TS.288.A: Genetic Testing for Limb Girdle Muscular Dystrophy
Effective 07/01/2022
-
MOL.TS.290.A: Genetic Testing for Facioscapulohumeral Muscular Dystrophy
Effective 07/01/2022
-
MOL.TS.294.A: Decipher Prostate Cancer Classifier
Effective 07/01/2022
-
MOL.TS.295.B: Oncotype DX for Prostate Cancer
Effective 07/01/2022
-
MOL.TS.296.A: ProMark Proteomic Prognostic Test
Effective 07/01/2022
-
MOL.TS.297.A: Prolaris
Effective 07/01/2022
-
MOL.TS.300.A: Macula Risk
Effective 07/01/2022
-
MOL.TS.301.A: Neurofibromatosis Type 1 Genetic Testing
Effective 07/01/2022
-
MOL.TS.302.A: Legius Syndrome Genetic Testing
Effective 07/01/2022
-
MOL.TS.306.A: Whole Genome Sequencing
Effective 07/01/2022
-
MOL.TS.307.A: AlloSure for Kidney Transplant Rejection
Effective 07/01/2022
-
MOL.TS.308.A: Hemoglobinopathies Genetic Testing
Effective 07/01/2022
-
MOL.TS.309.A: Friedreich Ataxia Genetic Testing
Effective 07/01/2022
-
MOL.TS.310.A: Hereditary Ataxia Multigene Panel Testing
Effective 07/01/2022
-
MOL.TS.311.A: Spinocerebellar Ataxia Genetic Testing
Effective 07/01/2022
-
MOL.TS.312.A: Myotonic Dystrophy Type 1 Genetic Testing
Effective 07/01/2022
-
MOL.TS.313.A: Somatic Mutation Testing Hematological Malignancies
Effective 07/01/2022
-
MOL.TS.324.A: CHARGE Syndrome Genetic Testing
Effective 07/01/2022
-
MOL.TS.340.A: GeneSight Psychotropic Test
Effective 07/01/2022
-
MOL.TS.344.A: Chromosomal Microarray for Solid Tumors
Effective 07/01/2022
-
MOL.TS.356.A: Microsatellite Instability and Immunohistochemistry Testing in Cancer
Effective 07/01/2022
-
MOL.TS.360.A: Inherited Bone Marrow Failure Syndrome (IBMFS) Testing
Effective 07/01/2022
-
MOL.TS.361.A: Human Platelet and Red Blood Cell Antigen Genotyping
Effective 07/01/2022
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MOL.TS.122.A: Afirma Thyroid Cancer Classifier Tests
Effective 07/01/2022