MolDX: Repeat Germline Testing Local Coverage Determination; Associated Billing and Coding Article

This Local Coverage Determination (LCD) has completed the Open Public Meeting comment period and is now finalized under contractor numbers: 02101 (AK), 03101 (AZ), 02201 (ID), 03201 (MT), 03301 (ND), 02301 (OR), 03401 (SD), 03501 (UT), 02401 (WA), and 03601 (WY).

Medicare Coverage Database Number LCD Title
L38353 MolDX: Repeat Germline Testing


Medicare Coverage Database Number Billing and Coding Article Title
A57332 Billing and Coding: MolDX: Repeat Germline Testing


Effective Date: August 03, 2020
Summary: Germline testing, including using gene panels that contain some genetic content that has already been tested in the same Medicare beneficiary may be considered reasonable and necessary provided that there is established clinical utility present in the remaining, non-duplicative genetic components of the test. Unit of Service (UOS) for any one specific germline DNA or RNA-based test is limited to one per lifetime. Examples of germline tests include (but are not limited to) single gene and gene panel tests for: hereditary cancer syndromes or cancer predisposition, inherited disorders, and pharmacogenomics/cytochrome P450 testing.

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            Last Updated Mon, 15 Jun 2020 18:55:19 +0000