May 6, 2014 – Revised: December 22, 2014
Molecular Pathology (MoPath): Approved Gene Testing
Effective for services performed on or after 11/3/2014, coverage requirements for this test is addressed in CGS's Local Coverage Determination (LCD) for Molecular Diagnostic Tests (L35394). The instructions in this article apply to services provided before this date.
Based on a review of the current available literature, CGS has determined that testing for the following genes/gene components meets Medicare criteria for covered services.
CPT codes | CPT Descriptor |
---|---|
81206 | BCR/ABL1 gene major bp |
81207 | BCR/ABL1 gene minor bp |
81208 | BCR/ABL1 gene other bp |
81210 | BRAF gene |
81211 | BRCA1 & 2 seq and com dup/del |
81212 | BRCA1 & 2 185&58385&6174 var |
81213 | BRCA1 & 2 uncom dup/del var |
81214 | BRCA1 full seq & com dup/del |
81215 | BRCA1 full gene known fam variant |
81217 | BRCA2 gene known fam variant |
81225 | CYP2C19 gene com variants |
81226 | CYP2D6 gene com variants |
81227 | CYP2C9 gene com variants |
81235 | EGFR (epidermal growth receptor)(non-small cell lung) gene analyisis, common variants (eg exon 19 LREA deletion, L858R, T790M, G719A, G719S, L861Q) |
81240 | F2 gene |
81241 | F5 gene |
81245 | FLT3 gene |
81256 | HFE gene |
81261 | IGH gene rearrange amp meth |
81262 | IGH gene rraange dir probe |
81263 | IGH vari regional mutation |
81264 | IGK, gr |
81265 | STR markers specimen anal |
81266 | STR add (for translplants) |
81267 | Chimerism anal no cell selec |
81268 | Chimerism anal w/cell selec |
81270 | JAK2 gene |
81275 | KRAS gene |
81287 | MGMT, ma |
81291 | MTHFR gene |
81292 | MLH1 gene full seq |
81293 | MLH1 gene known variants |
81294 | MLH1 gene dup/delete variant |
81295 | MSH2 gene full seq |
81296 | MSH2, gene known variants |
81297 | MSH2, gene dup/delete variants |
81298 | MSH6 gene full seq |
81299 | MSH6 gene known variants |
81300 | MSH6 gene dup/delete variants |
81401 | MUTYH, cv |
81301 | Microsatellite instability |
81310 | NPM1 gene |
81315 | PML/RAR alpha com breakpoints |
81316 | PML/RAR alpha com 1 breakpoint |
81317 | PMS2 gene full seq analysis |
81318 | PMS2 known familial variants |
81319 | PMS2 gene dup/delete variants |
81321 | PTEN gene analyis, full sequence |
81322 | PTEN, known familial variants |
81323 | PTEN, duplication/deletion |
81332 | SERPINA1 gene, cv |
81340 | TRB @gene rearrange amplify |
81341 | TRB @gene rearrange dirporbe |
81342 | TRG gene rearrangement anal |
81370 | HLA I & II typng lr |
81371 | HLA I & II type verify lr |
81372 | HLA I typing complete lr |
81373 | HLA I typing 1 locus lr |
81374 | HLA I typing 1 antigen lr |
81375 | HLA II typing ag equiv lr |
81376 | HLA II typing 1 locus lr |
81377 | HLA II type 1 ag equiv lr |
81378 | HLA I & II typing hr |
81379 | HLA I typing complete hr |
81380 | HLA I typing 1 locus hr |
81381 | HLA I typing 1 allele hr |
81382 | HLA II typing 1 loc hr |
81383 | HLA II typing 1 allele hr |
81400 | ACE, idv |
81400 | F2 |
81400 | F5 |
81400 | F7 |
81400 | F13B |
81400 | FGB |
81400 | Human Platelet Antigen ANTIGEN 1(HPA-1) |
81400 | Human Platelet Antigen ANTIGEN 2(HPA-2) |
81400 | Human Platelet Antigen ANTIGEN 3(HPA-3) |
81400 | Human Platelet Antigen ANTIGEN 4(HPA-4) |
81400 | Human Platelet Antigen ANTIGEN 5(HPA-5) |
81400 | Human Platelet Antigen ANTIGEN 6(HPA-6) |
81400 | Human Platelet Antigen ANTIGEN 9(HPA-9) |
81400 | Human Platelet Antigen ANTIGEN 15 (HPA-15) |
81400 | IL28B, rs12979860 |
81400 | SERPINE1 |
81401 | ABL1 (c-abl oncogene 1 |
81401 | CCND1/IGH |
81401 | CYFB-MYH11 |
81401 | E2A/PBX1 |
81401 | EML4-ALK |
81401 | ETV6-RUNX1 |
81401 | EWSR1/ERG |
81401 | EWSR1/FLI1 |
81401 | EWSR1/WT1 |
81401 | F11coagulation factor XI |
81401 | FIP1L1-PDGFR |
81401 | FOXO1/PAX3 ta, quant/qual |
81401 | FOXO1/PAX7 ta, quant/qual |
81401 | MUTYH (mutY homolog [E.coli]) |
81401 | PAX8/PPARG |
81401 | RUNX1/RUNX1T1 |
81401 | TPMT (thiopurine S-methyltransferase), cv |
81401 | TYMS (thymidylate synthetase), trv |
81401 | VWF (von Willebrand factor), cv |
81402 | IGH_BCL2 |
81402 | KIT |
81403 | ABL1 (c-abl oncogene 1) |
81403 | CEBPA |
81403 | F8 (coagulation factor VIII) |
81403 | IDH1 |
81403 | IDH2 (isocitrate dehydrogenase 2) |
81403 | JAK2 (Janus kinase 2) |
81403 | Known familial variant |
81403 | VHL (von Hippel-Lindau tumor suppressor)dup_del |
81403 | VWF (von Willebrand factor), tsa |
81404 | CDKN2A (cyclin-dependent kinase inhibitor 2A |
81404 | KIT (C-kit) (v-kit Hardy-Zuckerman 4 feline sarcoma), tga |
81404 | NRAS (neuroblastoma RAS viral oncogene homolog) |
81404 | PDGFRA (platelet-derived growth factor receptor alpha polypeptide), tga (e |
81404 | PRSS1 (protease, serine, 1 [trypsin 1]), fgs |
81404 | VHL (von Hippel-Lindau tumor suppressor), fgs |
81403 | VWF (Type 2A, 2B, 2M and Exon 28) |
81405 | MEN1 (multiple endocrine neoplasia I), fgs |
81405 | VWF (von Willebrand factor), tsa |
81406 | CAPN3 (Calpain 3) |
81403 | RET, kfv |
81404 | RET, cv |
81405 | RET, tsa |
81406 | RET (ret-proto-oncogene), fgs |