MolDX: Genomic Health Oncotype DX Prostate Cancer Assay LCD – RH
December 4, 2018The following JF Local Coverage Determination (LCD) has been revised under contractor numbers 02102 (AK), 02202 (ID), 02302 (OR), 02402 (WA), 03102 (AZ), 03202 (MT), 03302 (ND), 03402 (SD), 03502 (UT), 03602 (WY).
Medicare Coverage Database (MCD) Number: L36368
LCD Title: MolDX: Genomic Health™ Oncotype DX® Prostate Cancer Assay
Effective Date: July 01, 2018
Summary of Changes: The following changes are made including CPT/HCPCS Q3 Updates:
- Added CPT/HCPCS Code 0047U, Oncology (prostate), mRNA, gene expression profiling by real-time RT-PCR of 17 genes (12 content and 5 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a risk score
- Deleted CPT/HCPCS Code: 81479, Unlisted molecular pathology procedure
- Removed CDD from title.
The procedure code 0047U will not go into the system until 10/1/18, though claims are retro-effective to 7/1/18. Providers must use 81479 until 10/1/18.