Prior authorization codes

Commonwealth Care Alliance

Active CPT codes that appear on the extracted prior authorization list for this health plan.

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Check a specific CPT

CodeProcedure / ServiceEffectiveRevisedConfidenceSource
1000C
metabolism), gene analysis, common variant(s) (eg, - >A, c.173+ >T)
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
1298C
hypercoagulability) gene analysis, common variants (eg, 677T, )
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
1639G
metabolism), gene analysis, common variant(s) (eg, - >A, c.173+ >T)
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81105
Human Platelet Antigen 1 genotyping (HPA-1), ITGB3 (integrin, beta 3 [platelet
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81106
Human Platelet Antigen 2 genotyping (HPA-2), GP1BA (glycoprotein Ib [platelet]
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81107
Human Platelet Antigen 3 genotyping (HPA-3), ITGA2B (integrin, alpha 2b [platelet
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81108
Human Platelet Antigen 4 genotyping (HPA-4), ITGB3 (integrin, beta 3 [platelet
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81109
Human Platelet Antigen 5 genotyping (HPA-5), ITGA2 (integrin, alpha 2 [CD49B
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81110
Human Platelet Antigen 6 genotyping (HPA-6w), ITGB3 (integrin, beta 3 [platelet
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81111
Human Platelet Antigen 9 genotyping (HPA-9w), ITGA2B (integrin, alpha 2b [platelet
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81112
Human Platelet Antigen 15 genotyping (HPA-15), CD109 (CD109 molecule) (eg
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81120
IDH1 (isocitrate dehydrogenase 1 [NADP+], soluble) (eg, glioma), common variants
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81121
IDH2 (isocitrate dehydrogenase 2 [NADP+], mitochondrial) (eg, glioma), common
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81161
DMD (dystrophin) (eg, Duchenne/Becker muscular dystrophy) deletion analysis, and
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81162
CPT codes removed
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81163
CPT codes removed
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81164
CPT codes removed
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81165
CPT codes removed
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81166
CPT codes removed
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81167
CPT codes removed
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81168
CCND1/IGH (t(11;14)) (eg, mantle cell lymphoma) translocation analysis, major
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81170
ABL1 (ABL proto-oncogene 1, non-receptor tyrosine kinase) (eg, acquired imatinib
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81171
AFF2 (ALF transcription elongation factor 2 [FMR2]) (eg, fragile X intellectual
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81172
AFF2 (ALF transcription elongation factor 2 [FMR2]) (eg, fragile X intellectual
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81173
AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81174
AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81175
ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81176
ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81177
ATN1 (atrophin 1) (eg, dentatorubral-pallidoluysian atrophy) gene analysis
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81178
ATXN1 (ataxin 1) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81179
ATXN2 (ataxin 2) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81180
ATXN3 (ataxin 3) (eg, spinocerebellar ataxia, Machado-Joseph disease) gene analysis
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81181
ATXN7 (ataxin 7) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81182
ATXN8OS (ATXN8 opposite strand [non-protein coding]) (eg, spinocerebellar ataxia)
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81183
ATXN10 (ataxin 10) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81184
CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81185
CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81186
CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81187
CNBP (CCHC-type zinc finger nucleic acid binding protein) (eg, myotonic dystrophy
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81188
CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; evaluation to
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81189
CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; full gene sequence
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81190
CSTB (cystatin B) (eg, Unverricht-Lundborg disease) gene analysis; known familial
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81191
NTRK1 (neurotrophic receptor tyrosine kinase 1) (eg, solid tumors) translocation
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81192
NTRK2 (neurotrophic receptor tyrosine kinase 2) (eg, solid tumors) translocation
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81193
NTRK3 (neurotrophic receptor tyrosine kinase 3) (eg, solid tumors) translocation
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81194
NTRK (neurotrophic receptor tyrosine kinase 1, 2, and 3) (eg, solid tumors)
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81200
ASPA (aspartoacylase) (eg, Canavan disease) gene analysis, common variants (eg
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81201
APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis [FAP]
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81202
APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis [FAP]
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81203
APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis [FAP]
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81204
AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81205
BCKDHB (branched-chain keto acid dehydrogenase E1, beta polypeptide) (eg, maple
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81206
BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; major
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81207
BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; minor
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81208
BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; other
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81209
BLM (Bloom syndrome, RecQ helicase-like) (eg, Bloom syndrome) gene analysis
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81210
BRAF (B-Raf proto-oncogene, serine/threonine kinase) (eg, colon cancer, melanoma)
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81212
CPT codes removed
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81215
CPT codes removed
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81216
CPT codes removed
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81217
refer to Genetic Testing: BRCA-Related Breast and/or Ovarian Cancer Syndrome
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81218
CEBPA (CCAAT/enhancer binding protein [C/EBP], alpha) (eg, acute myeloid
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81219
CALR (calreticulin) (eg, myeloproliferative disorders), gene analysis, common
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81220
CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81221
CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81222
CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81223
CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81224
CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81225
CYP2C19 (cytochrome P450, family 2, subfamily C, polypeptide 19) (eg, drug
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81226
CYP2D6 (cytochrome P450, family 2, subfamily D, polypeptide 6) (eg, drug
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81227
CYP2C9 (cytochrome P450, family 2, subfamily C, polypeptide 9) (eg, drug
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81230
CYP3A4 (cytochrome P450 family 3 subfamily A member 4) (eg, drug metabolism)
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81231
CYP3A5 (cytochrome P450 family 3 subfamily A member 5) (eg, drug metabolism)
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81232
DPYD (dihydropyrimidine dehydrogenase) (eg, 5-fluorouracil/5-FU and capecitabine
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81233
BTK (Bruton's tyrosine kinase) (eg, chronic lymphocytic leukemia) gene analysis
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81234
DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81235
EGFR (epidermal growth factor receptor) (eg, non-small cell lung cancer) gene
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81236
EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81237
EZH2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, diffuse large
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81238
F9 (coagulation factor IX) (eg, hemophilia B), full gene sequence
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81239
DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81240
F2 (prothrombin, coagulation factor II) (eg, hereditary hypercoagulability) gene
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81241
F5 (coagulation factor V) (eg, hereditary hypercoagulability) gene analysis, Leiden
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81242
FANCC (Fanconi anemia, complementation group C) (eg, Fanconi anemia, type C)
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81243
FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81244
FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81245
FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81246
FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81247
G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81248
G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81249
G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81250
G6PC (glucose-6-phosphatase, catalytic subunit) (eg, Glycogen storage disease, type
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81251
GBA (glucosidase, beta, acid) (eg, Gaucher disease) gene analysis, common variants
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81252
GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81253
GJB2 (gap junction protein, beta 2, 26kDa, connexin 26) (eg, nonsyndromic hearing
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81254
GJB6 (gap junction protein, beta 6, 30kDa, connexin 30) (eg, nonsyndromic hearing
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81255
HEXA (hexosaminidase A [alpha polypeptide]) (eg, Tay-Sachs disease) gene analysis
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81256
HFE (hemochromatosis) (eg, hereditary hemochromatosis) gene analysis, common
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81257
HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81258
HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81259
HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81260
IKBKAP (inhibitor of kappa light polypeptide gene enhancer in B-cells, kinase
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81261
IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell)
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81262
IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell)
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81263
IGH@ (Immunoglobulin heavy chain locus) (eg, leukemia and lymphoma, B-cell)
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81264
IGK@ (Immunoglobulin kappa light chain locus) (eg, leukemia and lymphoma, B-cell)
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81265
Comparative analysis using Short Tandem Repeat (STR) markers; patient and
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81266
Comparative analysis using Short Tandem Repeat (STR) markers; each additional
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81267
Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81268
Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81269
HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81270
JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) gene analysis, p.Val617Phe
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81271
HTT (huntingtin) (eg, Huntington disease) gene analysis; evaluation to detect
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81272
KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81273
KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog)
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81274
HTT (huntingtin) (eg, Huntington disease) gene analysis; characterization of alleles
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81275
KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81276
KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81277
Cytogenomic neoplasia (genome-wide) microarray analysis, interrogation of genomic
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81278
IGH@/BCL2 (t(14;18)) (eg, follicular lymphoma) translocation analysis, major
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81279
JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) targeted sequence analysis
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81283
FNL3 (interferon, lambda 3) (eg, drug response), gene analysis, rs12979860 variant
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81284
FXN (frataxin) (eg, Friedreich ataxia) gene analysis; evaluation to detect abnormal
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81285
FXN (frataxin) (eg, Friedreich ataxia) gene analysis; characterization of alleles (eg
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81286
FXN (frataxin) (eg, Friedreich ataxia) gene analysis; full gene sequence
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81287
MGMT (O-6-methylguanine-DNA methyltransferase) (eg, glioblastoma multiforme)
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81288
MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81289
FXN (frataxin) (eg, Friedreich ataxia) gene analysis; known familial variant(s)
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81290
MCOLN1 (mucolipin 1) (eg, Mucolipidosis, type IV) gene analysis, common variants
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81291
MTHFR (5,10-methylenetetrahydrofolate reductase) (eg, hereditary
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81292
MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81293
MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81294
MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81295
MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81296
MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81297
MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81298
MSH6 (mutS homolog 6 [E. coli]) (eg, hereditary non-polyposis colorectal cancer
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81299
MSH6 (mutS homolog 6 [E. coli]) (eg, hereditary non-polyposis colorectal cancer
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81300
MSH6 (mutS homolog 6 [E. coli]) (eg, hereditary non-polyposis colorectal cancer
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81301
Microsatellite instability analysis (eg, hereditary non-polyposis colorectal cancer
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81302
MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; full
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81303
MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; known
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81304
MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81305
MYD88 (myeloid differentiation primary response 88) (eg, Waldenstrom's
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81306
NUDT15 (nudix hydrolase 15) (eg, drug metabolism) gene analysis, common
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81307
PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81308
PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81309
PIK3CA (phosphatidylinositol-4, 5-biphosphate 3-kinase, catalytic subunit alpha) (eg
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81310
NPM1 (nucleophosmin) (eg, acute myeloid leukemia) gene analysis, exon 12 variants
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81311
NRAS (neuroblastoma RAS viral [v-ras] oncogene homolog) (eg, colorectal
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81312
PABPN1 (poly[A] binding protein nuclear 1) (eg, oculopharyngeal muscular
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81313
PCA3/KLK3 (prostate cancer antigen 3 [non-protein coding]/kallikrein-related
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81314
PDGFRA (platelet-derived growth factor receptor, alpha polypeptide) (eg
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81315
PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81316
PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81317
PMS2 (postmeiotic segregation increased 2 [S. cerevisiae]) (eg, hereditary non
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81318
PMS2 (postmeiotic segregation increased 2 [S. cerevisiae]) (eg, hereditary non
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81319
PMS2 (postmeiotic segregation increased 2 [S. cerevisiae]) (eg, hereditary non
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81320
PLCG2 (phospholipase C gamma 2) (eg, chronic lymphocytic leukemia) gene analysis
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81321
PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81322
PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81323
PTEN (phosphatase and tensin homolog) (eg, Cowden syndrome, PTEN hamartoma
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81324
PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81325
PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81326
PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81327
SEPT9 (Septin9) (eg, colorectal cancer) promoter methylation analysis
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81328
SLCO1B1 (solute carrier organic anion transporter family, member 1B1) (eg, adverse
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81329
SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81330
SMPD1(sphingomyelin phosphodiesterase 1, acid lysosomal) (eg, Niemann-Pick
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81331
SNRPN/UBE3A (small nuclear ribonucleoprotein polypeptide N and ubiquitin protein
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81332
SERPINA1 (serpin peptidase inhibitor, clade A, alpha-1 antiproteinase, antitrypsin
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81333
TGFBI (transforming growth factor beta-induced) (eg, corneal dystrophy) gene
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81334
RUNX1 (runt related transcription factor 1) (eg, acute myeloid leukemia, familial
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81335
TPMT (thiopurine S-methyltransferase) (eg, drug metabolism), gene analysis
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81336
SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81337
SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81338
MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81339
MPL (MPL proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81340
TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81341
TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81342
TRG@ (T cell antigen receptor, gamma) (eg, leukemia and lymphoma), gene
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81343
PPP2R2B (protein phosphatase 2 regulatory subunit Bbeta) (eg, spinocerebellar
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81344
TBP (TATA box binding protein) (eg, spinocerebellar ataxia) gene analysis, evaluation
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81345
TERT (telomerase reverse transcriptase) (eg, thyroid carcinoma, glioblastoma
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81346
TYMS (thymidylate synthetase) (eg, 5-fluorouracil/5-FU drug metabolism), gene
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81347
SF3B1 (splicing factor [3b] subunit B1) (eg, myelodysplastic syndrome/acute myeloid
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81348
SRSF2 (serine and arginine-rich splicing factor 2) (eg, myelodysplastic syndrome
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81349
Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81350
UGT1A1 (UDP glucuronosyltransferase 1 family, polypeptide A1) (eg, drug
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81351
TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; full gene
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81352
TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; targeted
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81353
TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; known familial
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81355
VKORC1 (vitamin K epoxide reductase complex, subunit 1) (eg, warfarin
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81357
U2AF1 (U2 small nuclear RNA auxiliary factor 1) (eg, myelodysplastic syndrome
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81360
ZRSR2 (zinc finger CCCH-type, RNA binding motif and serine/arginine-rich 2) (eg
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81361
HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81362
HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81363
HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81364
HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81370
HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, -C
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81371
HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, and
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81372
HLA Class I typing, low resolution (eg, antigen equivalents); complete (ie, HLA-A, -B
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81373
HLA Class I typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-A, -B
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81374
HLA Class I typing, low resolution (eg, antigen equivalents); one antigen equivalent
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81375
HLA Class II typing, low resolution (eg, antigen equivalents); HLA-DRB1/3/4/5 and
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81376
HLA Class II typing, low resolution (eg, antigen equivalents); one locus (eg, HLA
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81377
HLA Class II typing, low resolution (eg, antigen equivalents); one antigen equivalent
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81378
HLA Class I and II typing, high resolution (ie, alleles or allele groups), HLA-A, -B, -C
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81379
HLA Class I typing, high resolution (ie, alleles or allele groups); complete (ie, HLA-A
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81380
HLA Class I typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-A
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81381
HLA Class I typing, high resolution (ie, alleles or allele groups); one allele or allele
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81382
HLA Class II typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81383
HLA Class II typing, high resolution (ie, alleles or allele groups); one allele or allele
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81400
Molecular pathology procedure, Level 1 (eg, identification of single germline variant
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81401
Molecular pathology procedure, Level 2 (eg, 2-10 SNPs, 1 methylated variant, or 1
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81402
Molecular pathology procedure, Level 3 (eg, >10 SNPs, 2-10 methylated variants, or
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81403
Molecular pathology procedure, Level 4 (eg, analysis of single exon by DNA sequence
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81404
Molecular pathology procedure, Level 5 (eg, analysis of 2-5 exons by DNA sequence
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81405
Molecular pathology procedure, Level 6 (eg, analysis of 6-10 exons by DNA sequence
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81406
Molecular pathology procedure, Level 7 (eg, analysis of 11-25 exons by DNA
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81407
Molecular pathology procedure, Level 8 (eg, analysis of 26-50 exons by DNA
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81408
Molecular pathology procedure, Level 9 (eg, analysis of >50 exons in a single gene by
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81410
Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81411
Aortic dysfunction or dilation (eg, Marfan syndrome, Loeys Dietz syndrome, Ehler
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81412
Ashkenazi Jewish associated disorders (eg, Bloom syndrome, Canavan disease, cystic
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81413
Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81414
Cardiac ion channelopathies (eg, Brugada syndrome, long QT syndrome, short QT
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81415
Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81416
Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81417
Exome (eg, unexplained constitutional or heritable disorder or syndrome); re
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81418
Drug metabolism (eg, pharmacogenomics) genomic sequence analysis panel, must
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81419
Epilepsy genomic sequence analysis panel, must include analyses for ALDH7A1
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81422
Fetal chromosomal microdeletion(s) genomic sequence analysis (eg, DiGeorge
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81425
Genome (eg, unexplained constitutional or heritable disorder or syndrome)
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81426
Genome (eg, unexplained constitutional or heritable disorder or syndrome)
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81427
Genome (eg, unexplained constitutional or heritable disorder or syndrome); re
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81430
Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome)
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81431
Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome)
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81432
Hereditary breast cancer-related disorders (eg, hereditary breast cancer, hereditary
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81433
Hereditary breast cancer-related disorders (eg, hereditary breast cancer, hereditary
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81434
Hereditary retinal disorders (eg, retinitis pigmentosa, Leber congenital amaurosis
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81435
Hereditary colon cancer disorders (eg, Lynch syndrome, PTEN hamartoma syndrome
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81436
2/12/26 Removed deleted codes
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81437
Hereditary neuroendocrine tumor disorders (eg, medullary thyroid carcinoma
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81438
2/12/26 Removed deleted codes
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81439
Hereditary cardiomyopathy (eg, hypertrophic cardiomyopathy, dilated cardiomyopathy
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81440
Nuclear encoded mitochondrial genes (eg, neurologic or myopathic phenotypes), genomic
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81441
Inherited bone marrow failure syndromes (IBMFS) (eg, Fanconi anemia, dyskeratosis
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81442
Noonan spectrum disorders (eg, Noonan syndrome, cardio-facio-cutaneous syndrome
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81445
Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81448
Hereditary peripheral neuropathies (eg, Charcot-Marie-Tooth, spastic paraplegia)
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81449
Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81450
Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81451
Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81455
Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81456
Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81457
Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81458
Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81459
Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81460
Whole mitochondrial genome (eg, Leigh syndrome, mitochondrial
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81462
Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81463
Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81464
Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81465
Whole mitochondrial genome large deletion analysis panel (eg, Kearns-Sayre
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81470
X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID)
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81471
X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID)
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81479
Unlisted molecular pathology procedure
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81490
Autoimmune (rheumatoid arthritis), analysis of 12 biomarkers using immunoassays
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81493
Coronary artery disease, mRNA, gene expression profiling by real-time RT-PCR of 23
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81500
Oncology (ovarian), biochemical assays of two proteins (CA-125 and HE4), utilizing
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81503
Oncology (ovarian), biochemical assays of five proteins (CA-125, apolipoprotein A1
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81504
Oncology (tissue of origin), microarray gene expression profiling of > 2000 genes
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81506
Endocrinology (type 2 diabetes), biochemical assays of seven analytes (glucose
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81508
1/1/25 Template and CCA product update. Code updates: CPT , no longer
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81509
1/1/25 Template and CCA product update. Code updates: CPT , no longer
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81510
1/1/25 Template and CCA product update. Code updates: CPT , no longer
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81511
1/1/25 Template and CCA product update. Code updates: CPT , no longer
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81512
1/1/25 Template and CCA product update. Code updates: CPT , no longer
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81513
1/1/25 Template and CCA product update. Code updates: CPT , no longer
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81514
1/1/25 Template and CCA product update. Code updates: CPT , no longer
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81517
Liver disease, analysis of 3 biomarkers (hyaluronic acid [HA], procollagen III amino
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81518
Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 11 genes
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81519
Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 21 genes
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81520
Oncology (breast), mRNA gene expression profiling by hybrid capture of 58 genes (50
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81521
Oncology (breast), mRNA, microarray gene expression profiling of 70 content genes
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81522
Oncology (breast), mRNA, gene expression profiling by RT-PCR of 12 genes (8
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81523
Oncology (breast), mRNA, next-generation sequencing gene expression profiling of
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81525
Oncology (colon), mRNA, gene expression profiling by real-time RT-PCR of 12 genes
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81528
1/1/25 Template and CCA product update. Code updates: CPT , no longer
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81529
Oncology (cutaneous melanoma), mRNA, gene expression profiling by real-time RT
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81535
Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81536
Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81538
Oncology (lung), mass spectrometric 8-protein signature, including amyloid A
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81539
authorization; CPT , do not require prior authorization
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81540
Oncology (tumor of unknown origin), mRNA, gene expression profiling by real-time
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81541
Oncology (prostate), mRNA gene expression profiling by real-time RT-PCR of 46
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81542
Oncology (prostate), mRNA, microarray gene expression profiling of 22 content
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81546
Oncology (thyroid), mRNA, gene expression analysis of 10,196 genes, utilizing fine
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81551
authorization; CPT , do not require prior authorization
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81552
Oncology (uveal melanoma), mRNA, gene expression profiling by real-time RT-PCR of
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81554
Pulmonary disease (idiopathic pulmonary fibrosis [IPF]), mRNA, gene expression
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81595
Cardiology (heart transplant), mRNA, gene expression profiling by real-time
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81596
Infectious disease, chronic hepatitis C virus (HCV) infection, six biochemical assays
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
81599
Unlisted multianalyte assay with algorithmic analysis
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
L3500
• : Molecular Pathology Procedures
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
S3840
DNA analysis for germline mutations of the RET proto-oncogene for susceptibility to
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
S3841
Genetic testing for retinoblastoma
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
S3842
Genetic testing for Von Hippel-Lindau disease
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
S3845
Genetic testing for alpha-thalassemia
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
S3846
Genetic testing for hemoglobin E beta-thalassemia
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
S3849
Genetic testing for Niemann-Pick disease
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
S3850
Genetic testing for sickle cell anemia
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
S3853
Genetic testing for myotonic muscular dystrophy
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
S3854
Gene expression profiling panel for use in the management of breast cancer
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
S3861
Genetic testing, sodium channel, voltage-gated, type V, alpha subunit (SCN5A) and
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
S3865
Comprehensive gene sequence analysis for hypertrophic cardiomyopathy
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
S3866
Genetic analysis for a specific gene mutation for hypertrophic cardiomyopathy
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline
S3870
Comparative genomic hybridization (CGH) microarray testing for developmental
2019-04-012019-01-2597%
[PDF] Genetic and Molecular Testing Medical Necessity Guideline