Laboratory Management

Date of Service and Effective Date of the Authorization Period

Effective 01/01/2021

Medical Necessity Review Information Requirements

Effective 01/01/2021

Molecular Pathology Tier 2 Molecular CPT Codes

Effective 01/01/2021

Unique Test Identifiers for Non-Specific Procedure Codes

Effective 01/01/2021

Confirmatory Genetic Testing

Effective 01/01/2021

Genetic Presymptomatic and Predictive Testing for Adult-Onset Conditions in Minors

Effective 01/01/2021

Genetic Testing by Multigene Panels

Effective 01/01/2021

Genetic Testing for Cancer Susceptibility and Hereditary Cancer Syndromes

Effective 01/01/2021

Genetic Testing for Carrier Status

Effective 01/01/2021

Genetic Testing for Known Familial Mutations

Effective 01/01/2021

Genetic Testing for Non-Medical Purposes

Effective 01/01/2021

Genetic Testing for Prenatal Screening and Diagnostic Testing

Effective 01/01/2021

Genetic Testing for the Screening, Diagnosis, and Monitoring of Cancer

Effective 01/01/2021

Genetic Testing for Variants of Uncertain Clinical Significance

Effective 01/01/2021

Genetic Testing to Diagnose Non-Cancer Conditions

Effective 01/01/2021

Genetic Testing to Predict Disease Risk

Effective 01/01/2021

Hereditary (Germline) Testing After Tumor (Somatic) Testing

Effective 01/01/2021

Investigational and Experimental Molecular and Genomic Testing

Effective 01/01/2021

Pharmacogenomic Testing for Drug Toxicity and Response

Effective 01/01/2021

Preimplantation Genetic Screening and Diagnosis

Effective 01/01/2021

4Kscore for Prostate Cancer Risk Assessment

Effective 01/01/2021

ABL Tyrosine Kinase Sequencing for Chronic Myeloid Leukemia

Effective 01/01/2021

Afirma Thyroid Cancer Classifier Tests

Effective 01/01/2021

AlloMap Gene Expression Profiling For Heart Transplant Rejection

Effective 01/01/2021

AlloSure for Kidney Transplant Rejection

Effective 01/01/2021

Alpha-1-Antitrypsin Deficiency Testing

Effective 01/01/2021

Amyotrophic Lateral Sclerosis (ALS) Genetic Testing

Effective 01/01/2021

Acute Myeloid Leukemia (AML) Genetic Testing

Effective 01/01/2021

Angelman Syndrome Testing

Effective 01/01/2021

Anser Testing

Effective 01/01/2021

APOE Variant Analysis for Alzheimer Disease

Effective 01/01/2021

Ashkenazi Jewish Carrier Screening

Effective 01/01/2021

Ataxia-Telangiectasia Testing

Effective 01/01/2021

BCR-ABL Negative Myeloproliferative Neoplasm Testing

Effective 01/01/2021

BCR-ABL Testing for Chronic Myeloid Leukemia

Effective 01/01/2021

Bloom Syndrome Testing

Effective 01/01/2021

BRCA Analysis

Effective 01/01/2021

BRCA Ashkenazi Jewish Founder Mutation Testing

Effective 01/01/2021

Breast Cancer Index for Breast Cancer Prognosis

Effective 01/01/2021

Brugada Syndrome Genetic Testing

Effective 01/01/2021

CADASIL Testing

Effective 01/01/2021

Canavan Disease Testing

Effective 01/01/2021

CellSearch Circulating Tumor Cell Count for Breast Cancer Prognosis

Effective 01/01/2021

Charcot-Marie-Tooth Neuropathy Testing

Effective 01/01/2021

CHARGE Syndrome Genetic Testing

Effective 01/01/2021

Chromosome Analysis for Blood and Bone Marrow

Effective 01/01/2021

Chromosome Analysis for Reproductive Disorders, Prenatal Testing, and Developmental Disorders

Effective 01/01/2021

Chromosomal Microarray for Prenatal Diagnosis

Effective 01/01/2021

Chromosomal Microarray for Solid Tumors

Effective 01/01/2021

Chromosomal Microarray Testing For Developmental Disorders

Effective 01/01/2021

Cologuard Screening for Colorectal Cancer

Effective 01/01/2021

ConfirmMDx for Prostate Cancer Risk Assessment

Effective 01/01/2021

Cxbladder

Effective 01/01/2021

Cystic Fibrosis Testing

Effective 01/01/2021

Decipher Prostate Cancer Classifier

Effective 01/01/2021

DecisionDx Uveal Melanoma

Effective 01/01/2021

Dentatorubral Pallidoluysian Atrophy Testing

Effective 01/01/2021

DermTech Pigmented Lesion Assay

Effective 01/01/2021

Duchenne and Becker Muscular Dystrophy Testing

Effective 01/01/2021

Ehlers-Danlos Syndrome Testing

Effective 01/01/2021

EndoPredict for Breast Cancer Prognosis

Effective 01/01/2021

Early Onset Familial Alzheimer Disease (EOFAD) Genetic Testing

Effective 01/01/2021

Exome Sequencing

Effective 01/01/2021

Expanded Carrier Screening Panels

Effective 01/01/2021

Factor II/Prothrombin Testing for Thrombophilia

Effective 01/01/2021

Factor V Leiden Testing for Thrombophilia_Eff01012021

Effective 01/01/2021

Familial Adenomatous Polyposis Testing

Effective 01/01/2021

Familial Hypercholesterolemia Genetic Testing

Effective 01/01/2021

Familial Malignant Melanoma Testing

Effective 01/01/2021

FibroTest/FibroSURE

Effective 01/01/2021

Flow Cytometry

Effective 01/01/2021

FMR1-Related Disorders (Fragile X) Genetic Testing

Effective 01/01/2021

Friedreich's Ataxia Genetic Testing

Effective 01/01/2021

Gaucher Disease Testing

Effective 01/01/2021

GeneSight Psychotropic Test

Effective 01/01/2021

Genetic Testing for Arrhythmogenic Right Ventricular Cardiomyopathy

Effective 01/01/2021

Genetic Testing for Autism, Intellectual Disability, and Developmental Delay

Effective 01/01/2021

Genetic Testing for Dilated Cardiomyopathy

Effective 01/01/2021

Genetic Testing for Epilepsy

Effective 01/01/2021

Genetic Testing for Facioscapulohumeral Muscular Dystrophy

Effective 01/01/2021

Genetic Testing for Hereditary Pancreatitis

Effective 01/01/2021

Genetic Testing for Limb Girdle Muscular Dystrophy

Effective 01/01/2021

Genetic Testing for Nonsyndromic Hearing Loss and Deafness

Effective 01/01/2021

Genitourinary Conditions: Molecular Testing

Effective 01/01/2021

Molecular Gastrointestinal Pathogen Panel (GIPP) Testing

Effective 01/01/2021

GPS Cancer (NantHealth)

Effective 01/01/2021

Hemoglobinopathies Genetic Testing

Effective 01/01/2021

Hereditary Ataxia Multigene Panel Testing

Effective 01/01/2021

Hereditary Cancer Syndrome Multigene Panels

Effective 01/01/2021

Hereditary Connective Tissue Disorder Testing

Effective 01/01/2021

Hereditary Hemochromatosis Testing

Effective 01/01/2021

HIV Tropism Testing for Maraviroc Response

Effective 01/01/2021

HLA Typing for Celiac Disease

Effective 01/01/2021

Huntington Disease Testing

Effective 01/01/2021

Hypertrophic Cardiomyopathy Testing

Effective 01/01/2021

Immunohistochemistry (IHC)

Effective 01/01/2021

In-vitro testing for HIV

Effective 01/01/2021

In-vitro testing for SARS-CoV-2 (COVID-19)

Effective 01/01/2021

Laboratory Claim Reimbursement

Effective 01/01/2021

Legius Syndrome Genetic Testing

Effective 01/01/2021

Li-Fraumeni Syndrome Testing

Effective 01/01/2021

Liquid Biopsy Testing - Solid Tumors

Effective 01/01/2021

Long QT Syndrome Testing

Effective 01/01/2021

Lyme Disease Testing

Effective 01/01/2021

Lynch Syndrome Genetic Testing

Effective 01/01/2021

Lynch Syndrome Tumor Screening - Second-Tier

Effective 01/01/2021

Macula Risk

Effective 01/01/2021

Mammaprint 70-Gene Breast Cancer Recurrence Assay

Effective 01/01/2021

Mammostrat Breast Cancer Recurrence Assay

Effective 01/01/2021

Marfan Syndrome Genetic Testing

Effective 01/01/2021

Medically Necessary Laboratory Testing

Effective 01/01/2021

Multiple Endocrine Neoplasia Type 1 (MEN1)

Effective 01/01/2021

Multiple Endocrine Neoplasia Type 2 (MEN2)

Effective 01/01/2021

MGMT Testing for Malignant Glioma Alkylating Agent Response

Effective 01/01/2021

Microsatellite Instability and Immunohistochemistry Testing in Cancer

Effective 01/01/2021

Mitochondrial Genetic Testing

Effective 01/01/2021

Maturity-Onset Diabetes of the Young (MODY) Testing

Effective 01/01/2021

MTHFR Variant Analysis for Hyperhomocysteinemia

Effective 01/01/2021

MUTYH Associated Polyposis Testing

Effective 01/01/2021

myChoice CDx

Effective 01/01/2021

Myotonic Dystrophy Type 1 Genetic Testing

Effective 01/01/2021

NETest

Effective 01/01/2021

Neurofibromatosis Type 1 Genetic Testing

Effective 01/01/2021

Niemann-Pick Disease Types A and B Testing

Effective 01/01/2021

Niemann-Pick Type C Testing

Effective 01/01/2021

Non-Invasive Prenatal Screening

Effective 01/01/2021

OncotypeDX Breast DCIS

Effective 01/01/2021

OncotypeDX for Breast Cancer Prognosis

Effective 01/01/2021

OncotypeDX for Colorectal Cancer Recurrence Risk

Effective 01/01/2021

OncotypeDX for Prostate Cancer

Effective 01/01/2021

OVA1

Effective 01/01/2021

PALB2 Genetic Testing for Breast Cancer Risk

Effective 01/01/2021

PancraGEN

Effective 01/01/2021

PCA3 Testing for Prostate Cancer

Effective 01/01/2021

Polymerase Gamma (POLG) Related Disorders Genetic Testing

Effective 01/01/2021

Prader-Willi Syndrome Testing

Effective 01/01/2021

Prenatal Aneuploidy FISH Testing

Effective 01/01/2021

Prenatal Maternal Serum Screening

Effective 01/01/2021

Prolaris

Effective 01/01/2021

ProMark Proteomic Prognostic Test

Effective 01/01/2021

Prosigna Breast Cancer Prognostic Gene Signature Assay

Effective 01/01/2021

PTEN Hamartoma Tumor Syndromes Testing

Effective 01/01/2021

Rett Syndrome Testing

Effective 01/01/2021

Molecular Respiratory Infection Pathogen Panel (RIPP) Testing

Effective 01/01/2021

SelectMDx

Effective 01/01/2021

Sept9 Methylation Analysis for Colorectal Cancer

Effective 01/01/2021

Somatic Mutation Testing - Hematological Malignancies

Effective 01/01/2021

Somatic Mutation Testing - Solid Tumors

Effective 01/01/2021

Spinal Muscular Atrophy Testing

Effective 01/01/2021

Spinocerebellar Ataxia Genetic Testing

Effective 01/01/2021

Thoracic Aortic Aneurysms and Dissections (TAAD) Panel Testing

Effective 01/01/2021

Tay Sachs Disease Testing

Effective 01/01/2021

ThyGeNEXT and ThyraMIR miRNA Gene Expression Classifier

Effective 01/01/2021

Thyroseq

Effective 01/01/2021

Tissue of Origin Testing for Cancer of Unknown Primary

Effective 01/01/2021

UroVysion FISH for Bladder Cancer

Effective 01/01/2021

VeriStrat Testing for NSCLC TKI Response

Effective 01/01/2021

Von Hippel-Lindau Disease Testing

Effective 01/01/2021

Whole Genome Sequencing

Effective 01/01/2021

MOL.AD.102.A: Molecular Pathology Tier 2 Molecular CPT Codes

Effective 07/01/2021

MOL.AD.107.A: Unique Test Identifiers for Non Specific Procedure Codes

Effective 07/01/2021

MOL.AD.304.A: Medical Necessity Review Information Requirements

Effective 07/01/2021

MOL.AD.314.A: Date of Service and Authorization Period Effective Date

Effective 07/01/2021

MOL.AD.364.A: Special Circumstances Influencing Coverage Determinations

Effective 07/01/2021

MOL.CU.109.A: Genetic Testing for Cancer Susceptibility and Hereditary Cancer Syndromes

Effective 07/01/2021

MOL.CU.110.A: Genetic Testing for Carrier Status

Effective 07/01/2021

MOL.CU.111.A: Genetic Testing for Non Medical Purposes

Effective 07/01/2021

MOL.CU.112.A: Genetic Testing for Prenatal Screening and Diagnostic Testing

Effective 07/01/2021

MOL.CU.11.3A: Genetic Testing for the Screening, Diagnosis, and Monitoring of Cancer

Effective 07/01/2021

MOL.CU.114.A: Genetic Testing to Diagnose Non Cancer Conditions

Effective 07/01/2021

MOL.CU.115.A: Genetic Testing to Predict Disease Risk

Effective 07/01/2021

MOL.CU.116.A: Genetic Testing by Multigene Panels

Effective 07/01/2021

MOL.CU.117.A Investigational and Experimental Molecular and Genomic Testing

Effective 07/01/2021

MOL.CU.118.A: Pharmacogenomic Testing for Drug Toxicity and Response

Effective 07/01/2021

MOL.CU.119.B: Preimplantation Genetic Screening and Diagnosis

Effective 07/01/2021

MOL.CU.246.A: Hereditary (Germline) Testing After Tumor (Somatic) Testing

Effective 07/01/2021

MOL.CU.256.A: Confirmatory Genetic Testing

Effective 07/01/2021

MOL.CU.291.A: Genetic Testing for Known Familial Mutations

Effective 07/01/2021

MOL.CU.292.A: Genetic Testing for Variants of Uncertain Clinical Significance

Effective 07/01/2021

MOL.CU.298.A: Genetic Presymptomatic and Predictive Testing for Adult Onset Conditions in Minors

Effective 07/01/2021

MOL.CS.103.A: Flow Cytometry

Effective 07/01/2021

MOL.CS.104.A: Immunohistochemistry

Effective 07/01/2021

MOL.CS.105.A: Laboratory Claim Reimbursement

Effective 07/01/2021

MOL.CS.106.A: Genitourinary Conditions Molecular Testing

Effective 07/01/2021

MOL.CS.108.A: UroVysion FISH for Bladder Cancer

Effective 07/01/2021

MOL.CS.146.A: HLA Typing for Celiac Disease

Effective 07/01/2021

MOL.CS.218.A: Prenatal Aneuploidy FISH Testing

Effective 07/01/2021

MOL.CS.277.A: Molecular Gastrointestinal Pathogen Panel (GIPP) Testing

Effective 07/01/2021

MOL.CS.289.A: Chromosome Analysis for Reproductive Disorders, Prenatal-Testing, and Developmental Disorders

Effective 07/01/2021

MOL.CS.293.A: Molecular Respiratory Infection Pathogen Panel (RIPP) Testing

Effective 07/01/2021

MOL.CS.321.A: In-vitro Testing for HIV

Effective 07/01/2021

MOL.CS.332.A: Lyme Disease Testing

Effective 07/01/2021

MOL.CS.333.A: Medically Necessary Laboratory Testing

Effective 07/01/2021

MOL.CS.353.A: In-vitro testing for SARS CoV-2 (COVID 19)

Effective 07/01/2021

MOL.CS.362.A: Human Papillomavirus (HPV) Molecular Testing

Effective 07/01/2021

MOL.CS.363.A: Pathology Testing with Mohs Micrographic Surgery

Effective 07/01/2021

MOL.TS.120.A: 4Kscore for Prostate Cancer Risk Assessment

Effective 07/01/2021

MOL.TS.121.A: ABL Tyrosine Kinase Sequencing for Chronic Myeloid Leukemia

Effective 07/01/2021

MOL.TS.123.A: AlloMap Gene Expression Profiling for Heart Transplant Rejection

Effective 07/01/2021

MOL.TS.124.A: Alpha 1 Antitrypsin Deficiency Testing

Effective 07/01/2021

MOL.TS.125.A: Amyotrophic Lateral Sclerosis (ALS) Genetic Testing

Effective 07/01/2021

MOL.TS.126.A: Angelman Syndrome Testing

Effective 07/01/2021

MOL.TS.127.A: Anser Testing

Effective 07/01/2021

MOL.TS.128.A: APOE Variant Analysis for Alzheimer Disease Testing

Effective 07/01/2021

MOL.TS.129.A: Ashkenazi Jewish Carrier Screening

Effective 07/01/2021

MOL.TS.130.A: Ataxia Telangiectasia Testing

Effective 07/01/2021

MOL.TS.131.A: BCR-ABL1 Testing for Chronic Myeloid Leukemia

Effective 07/01/2021

MOL.TS.132.A: Bloom Syndrome Testing

Effective 07/01/2021

MOL.TS.135.A: BRCA Ashkenazi Jewish Founder Mutation Testing

Effective 07/01/2021

MOL.TS.144.A: CADASIL Testing

Effective 07/01/2021

MOL.TS.145.A: Canavan Disease Testing

Effective 07/01/2021

MOL.TS.147.A: CellSearch Circulating Tumor Cell Count for Breast Cancer Prognosis

Effective 07/01/2021

MOL.TS.148.A: Charcot-Marie-Tooth Neuropathy Testing

Effective 07/01/2021

MOL.TS.149.A: Chromosomal Microarray for Prenatal Diagnosis

Effective 07/01/2021

MOL.TS.150.A: Chromosomal Microarray Testing For Developmental Disorders

Effective 07/01/2021

MOL.TS.151.A: Chromosome Analysis for Blood and Bone Marrow Cancers

Effective 07/01/2021

MOL.TS.152.A: Cologuard Screening for Colorectal Cancer

Effective 07/01/2021

MOL.TS.153.A: ConfirmMDx for Prostate Cancer Risk Assessment

Effective 07/01/2021

MOL.TS.158.A: Cystic Fibrosis Testing

Effective 07/01/2021

MOL.TS.159.A: Dentatorubral Pallidoluysian Atrophy Testing

Effective 07/01/2021

MOL.TS.161.A: Duchenne and Becker Muscular Dystrophy Testing

Effective 07/01/2021

MOL.TS.162A: Early Onset Familial Alzheimer Disease (EOFAD) Genetic Testing

Effective 07/01/2021

MOL.TS.164.A: SEPT9 Methylation Analysis for Colorectal Cancer

Effective 07/01/2021

MOL.TS.165.A: Expanded Carrier Screening Panels

Effective 07/01/2021

MOL.TS.166A: Factor II Prothrombin Testing for Thrombophilia

Effective 07/01/2021

MOL.TS.167.A: Factor V Leiden Testing for Thrombophilia

Effective 07/01/2021

MOL.TS.168.A: Familial Adenomatous Polyposis

Effective 07/01/2021

MOL.TS.169.A: Familial Hypercholesterolemia Genetic Testing

Effective 07/01/2021

MOL.TS.170.A: Familial Malignant Melanoma Testing

Effective 07/01/2021

MOL.TS.172.A: FMR1 Related Disorders (Fragile X) Genetic Testing

Effective 07/01/2021

MOL.TS.173.A: Gaucher Disease Testing

Effective 07/01/2021

MOL.TS.182.A: Hereditary Cancer Syndrome Multigene Panels

Effective 07/01/2021

MOL.TS.183.A: Hemochromatosis Testing

Effective 07/01/2021

MOL.TS.185.A: HIV Tropism Testing for Maraviroc Response

Effective 07/01/2021

MOL.TS.188.A: Huntington Disease

Effective 07/01/2021

MOL.TS.189.A: Hypertrophic Cardiomyopathy Testing

Effective 07/01/2021

MOL.TS.193.A: Li Fraumeni Syndrome

Effective 07/01/2021

MOL.TS.194.A: Liquid Biopsy Testing

Effective 07/01/2021

MOL.TS.196.A: Long QT Syndrome Testing

Effective 07/01/2021

MOL.TS.197.A: Lynch Syndrome Genetic Testing

Effective 07/01/2021

MOL.TS.199.A: Lynch Syndrome Tumor Screening - Second Tier

Effective 07/01/2021

MOL.TS.200.A: Mammaprint 70-Gene Breast Cancer Recurrence Assay

Effective 07/01/2021

MOL.TS.201.A: Mammostrat Breast Cancer Recurrence Assay

Effective 07/01/2021

MOL.TS.202.A: Marfan Syndrome Genetic Testing

Effective 07/01/2021

MOL.TS.203.A: MGMT Testing for Malignant Glioma Alkylating Agent Response

Effective 07/01/2021

MOL.TS.205.A: MTHFR Variant Analysis for Hyperhomocysteinemia

Effective 07/01/2021

MOL.TS.206.A: MUTYH Associated Polyposis Testing

Effective 07/01/2021

MOL.TS.207.A: Niemann-Pick Disease Types A and B Testing

Effective 07/01/2021

MOL.TS.208 A: Niemann-Pick Type C Testing

Effective 07/01/2021

MOL.TS.209.A: Non-Invasive Prenatal Screening

Effective 07/01/2021

MOL.TS.211.A: Oncotype DX for Breast Cancer Prognosis

Effective 07/01/2021

MOL.TS.213.A: Oncotype DX for Colorectal Cancer Recurrence Risk

Effective 07/01/2021

MOL.TS.215.A: PCA3 Testing for Prostate Cancer

Effective 07/01/2021

MOL.TS.216.A: Peutz-Jeghers Syndrome Testing

Effective 07/01/2021

MOL.TS.217.A: Prader-Willi Syndrome Testing

Effective 07/01/2021

MOL.TS.220.A: Prenatal Maternal Serum Screening

Effective 07/01/2021

MOL.TS.222.A: Prosigna Breast Cancer Prognostic Gene Signature Assay

Effective 07/01/2021

MOL.TS.223.A: PTEN Hamartoma Tumor Syndromes Testing

Effective 07/01/2021

MOL.TS.224.A: Rett Syndrome Testing

Effective 07/01/2021

MOL.TS.225.A: Spinal Muscular Atrophy Testing

Effective 07/01/2021

MOL.TS.226.A: Tay Sachs Disease Testing

Effective 07/01/2021

MOL.TS.227.A: Thoracic Aortic Aneurysms and Dissections TAAD Panel Testing

Effective 07/01/2021

MOL.TS.228.A: Tissue of Origin Testing for Cancer of Unknown Primary

Effective 07/01/2021

MOL.TS.230.A: Somatic Mutation Testing-Solid Tumors

Effective 07/01/2021

MOL.TS.232.A: VeriStrat Testing for NSCLC TKI Response

Effective 07/01/2021

MOL.TS.233.A: Von Hippel Lindau Disease Testing

Effective 07/01/2021

MOL.TS.234.A: EndoPredict for Breast Cancer Prognosis

Effective 07/01/2021

MOL.TS.235.A: Exome Sequencing

Effective 07/01/2021

MOL.TS.236.A: Cxbladder

Effective 07/01/2021

MOL.TS.238.A: BRCA Analysis

Effective 07/01/2021

MOL.TS.240.A: BCR ABL Negative Myeloproliferative Neoplasm Testing

Effective 07/01/2021

MOL.TS.241.A: GPS Cancer (NantHealth)

Effective 07/01/2021

MOL.TS.248.A: Breast Cancer Index for Breast Cancer Prognosis

Effective 07/01/2021

MOL.TS.250.A: NETest

Effective 07/01/2021

MOL.TS.251.A: PALB2 Genetic Testing for Breast Cancer Risk

Effective 07/01/2021

MOL.TS.254.A: DecisionDx Uveal Melanoma

Effective 07/01/2021

MOL.TS.255.A: Oncotype DX Breast DCIS

Effective 07/01/2021

MOL.TS.257.A: Genetic Testing for Epilepsy

Effective 07/01/2021

MOL.TS.258.A: Maturity Onset Diabetes of the Young (MODY) Testing

Effective 07/01/2021

MOL.TS.259.A: ThyGeNEXT and ThyraMIR miRNA Gene Expression Classifier

Effective 07/01/2021

MOL.TS.260.A: OVA1

Effective 07/01/2021

MOL.TS.261.A: Brugada Syndrome Genetic Testing

Effective 07/01/2021

MOL.TS.262.A: FibroTest FibroSURE

Effective 07/01/2021

MOL.TS.264.A: SelectMDx

Effective 07/01/2021

MOL.TS.266.A: Mitochondrial Disorders Genetic Testing

Effective 07/01/2021

MOL.TS.267.A: Ehlers Danlos Syndrome Testing

Effective 07/01/2021

MOL.TS.268.A: Hereditary Connective Tissue Disorder Testing

Effective 07/01/2021

MOL.TS.269.A: Genetic Testing for Autism, Intellectual Disability, and Developmental Delay

Effective 07/01/2021

MOL.TS.270.A: ThyroSeq

Effective 07/01/2021

MOL.TS.271.A: PancraGEN

Effective 07/01/2021

MOL.TS.273.A: Genetic Testing for Nonsyndromic Hearing Loss and Deafness

Effective 07/01/2021

MOL.TS.274.A: Acute Myeloid Leukemia AML Genetic Testing

Effective 07/01/2021

MOL.TS.276.A: Polymerase Gamma (POLG) Related Disorders Genetic Testing

Effective 07/01/2021

MOL.TS.281.A: Genetic Testing for Arrhythmogenic Right Ventricular Cardiomyopathy

Effective 07/01/2021

MOL.TS.282.A: DermTech Pigmented Lesion Assay

Effective 07/01/2021

MOL.TS.284.A: Genetic Testing for Dilated Cardiomyopathy

Effective 07/01/2021

MOL.TS.285.A: Multiple Endocrine Neoplasia Type 1 (MEN1)

Effective 07/01/2021

MOL.TS.286.A: Multiple Endocrine Neoplasia Type 2 (MEN2)

Effective 07/01/2021

MOL.TS.287.A: Genetic Testing for Hereditary Pancreatitis

Effective 07/01/2021

MOL.TS.288.A: Genetic Testing for Limb Girdle Muscular Dystrophy

Effective 07/01/2021

MOL.TS.290.A: Genetic Testing for Facioscapulohumeral Muscular Dystrophy

Effective 07/01/2021

MOL.TS.294.A: Decipher Prostate Cancer Classifier

Effective 07/01/2021

MOL.TS.295.A: Oncotype DX for Prostate Cancer

Effective 07/01/2021

MOL.TS.296.A: ProMark Proteomic Prognostic Test

Effective 07/01/2021

MOL.TS.297.A: Prolaris

Effective 07/01/2021

MOL.TS.300.A: Macula Risk

Effective 07/01/2021

MOL.TS.301.A: Neurofibromatosis Type 1 Genetic Testing

Effective 07/01/2021

MOL.TS.302.A: Legius Syndrome Genetic Testing

Effective 07/01/2021

MOL.TS.306.A: Whole Genome Sequencing

Effective 07/01/2021

MOL.TS.307.A: AlloSure for Kidney Transplant Rejection

Effective 07/01/2021

MOL.TS.308.A: Hemoglobinopathies Genetic Testing

Effective 07/01/2021

MOL.TS.309.A: Friedreich Ataxia Genetic Testing

Effective 07/01/2021

MOL.TS.310.A: Hereditary Ataxia Multigene Panel Testing

Effective 07/01/2021

MOL.TS.311.A: Spinocerebellar Ataxia Genetic Testing

Effective 07/01/2021

MOL.TS.312.A: Myotonic Dystrophy Type 1 Genetic Testing

Effective 07/01/2021

MOL.TS.313.A: Somatic Mutation Testing Hematological Malignancies

Effective 07/01/2021

MOL.TS.324.A: CHARGE Syndrome Genetic Testing

Effective 07/01/2021

MOL.TS.340.A: GeneSight Psychotropic Test

Effective 07/01/2021

MOL.TS.341.A: myChoice CDx

Effective 07/01/2021

MOL.TS.344.A: Chromosomal Microarray for Solid Tumors

Effective 07/01/2021

MOL.TS.356.A: Microsatellite Instability and Immunohistochemistry Testing in Cancer

Effective 07/01/2021

MOL.TS.360.A: Inherited Bone Marrow Failure Syndrome (IBMFS) Testing

Effective 07/01/2021

MOL.TS.361.A: Human Platelet and Red Blood Cell Antigen Genotyping

Effective 07/01/2021

MOL.TS.122.A: Afirma Thyroid Cancer Classifier Tests

Effective 07/01/2021