Excluded Genetic Test Reconsideration Requests and Process

This article applies to a specific gene that may include different tests from multiple labs. To reconsider a decision on a specific laboratory test, please follow the Technical Assessment Process outlined on the MolDX site. Although the Program Integrity Manual (PIM Chapter 13.11.E.2) does NOT allow reconsideration requests for NCDs, coverage provisions in interpretive manuals, draft, template or retired LCDs, individual claims, bulletins, articles, training material, and any instance in which an LCD doesn’t exist, Palmetto GBA will continue to accept and consider requests on excluded genetic tests. The reconsideration requirements have been modeled from the LCD reconsideration PIM language and will be used in support of this excluded service reconsideration process.