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December 30, 2015

CGS Local Coverage Determination (LCD) Policy Updates

The following LCDs have been released from draft into their final version. Please review them on the CGS website or click on the links provided. These policies will be effective February 1, 2015.

  • L36460 Bone Mass Measurement
  • L36487 MolDX: Chromosome 1p/19q deletion analysis
  • L36494 Minimally-Invasive Surgical (MIS) Fusion of the Sacroiliac (SI) Joint
  • L36458 MolDX: Breast Cancer Index℠ Genetic Assay
  • L36425 MolDX: Breast Cancer Assay: Prosigna

The following policy will be effective February 8, 2016.

  • L36469 Repetitive Transcranial Magnetic Stimulation (rTMS) in Adults with Treatment Resistant Major Depressive Disorder

These policies will be effective February 15, 2016.

  • L36485 MolDX: HLA-DQB1*06:02 Testing for Narcolepsy
  • L36456 MolDX: BRCA1 and BRCA2 Genetic Testing

Additional changes include:

  • Policies L36127 MolDX: Breast Cancer Assay: Prosigna and L36004 MolDX: Brease Cancer Index Genetic Assay will be retired 01/31/2016.
      o These policies are replaced with L36425 MolDX: Breast Cancer Assay: Prosigna and L36458 MolDX: Breast Cancer Index℠ Genetic Assay with new and updated information.
  • Policy L36115 MolDX: BRCA1 and BRCA2 Genetic Testing will be retired 02/14/2016.
      o It will be replaced with L36456 MolDX: BRCA1 and BRCA2 Genetic Testing with additional information from the original policy.


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