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MolDX: BRCA1 and BRCA2 Genetic Testing LCD – R3

March 5, 2019

The MolDX: BRCA1 and BRCA2 Genetic Testing LCD have been revised and published for notice under contract numbers: 01112 (NCA), 01182 (SCA), 01212 (AS, GU, HI, NMI) and 01312 (NV).

Medicare Coverage Database (MCD) Number: L36161
LCD Title: MolDX: BRCA1 and BRCA2 Genetic Testing
Effective Date: January 1, 2019
Summary of Changes: This LCD has been updated to include and/or remove CPT/HCPCS codes including the updates referenced below.

  • New/Revised CPT/HCPCS codes
    • 81163 BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (e.g., hereditary breast and ovarian cancer) gene analysis; full sequence analysis
    • 81164 BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (e.g., hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (i.e., detection of large gene rearrangements)
    • 81165 BRCA1 (BRCA1, DNA repair associated) (e.g., hereditary breast and ovarian cancer) gene analysis; full sequence analysis
    • 81166 BRCA1 (BRCA1, DNA repair associated) (e.g., hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (i.e., detection of large gene rearrangements)
    • 81167 BRCA2 (BRCA2, DNA repair associated) (e.g., hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (i.e., detection of large gene rearrangements)
  • Deleted CPT/HCPCS codes
    • 81211 BRCA1, BRCA2 (breast cancer 1 and 2) (e.g., hereditary breast and ovarian cancer) gene analysis; full sequence analysis and common duplication/deletion variants in BRCA1 (i.e., exon 13 del 3.835kb, exon 13 dup 6kb, exon 14-20 del 26kb, exon 22 del 510bp, exon 8-9 del 7.1kb)
    • 81213 BRCA1, BRCA2 (breast cancer 1 and 2) (e.g., hereditary breast and ovarian cancer) gene analysis; uncommon duplication/deletion variants
    • 81214 BRCA1 (breast cancer 1) (e.g., hereditary breast and ovarian cancer) gene analysis; full sequence analysis and common duplication/deletion variants (i.e., exon 13 del 3.835kb, exon 13 dup 6kb, exon 14-20 del 26kb, exon 22 del 510bp, exon 8-9 del 7.1kb)
  • Revisions under Indications and Limitations of Coverage to Criteria for Testing for breast and prostate indications.
  • Added verbiage under Multigene Panels to align with the National Coverage Determination (NCD90.2): Next Generation Sequencing (NGS), which describes the criteria under which contractors may cover NGS laboratory tests for patients with cancer.

Updated Bibliography #20 to update NCCN reference version to Version 2.2019.

Source: https://med.noridianmedicare.com/web/jeb/article-detail/-/view/10525/moldx-brca1-and-brca2-genetic-testing-lcd-r3

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