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May 6, 2014Revised: 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

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