Billing News Nov 2018



TPMT Gene Analysis is a New Medi-Cal Benefit

  • November 15, 2018

Effective for dates of service on or after November 1, 2018, CPT-4 code 81335 (TPMT [thiopurine S-methyltransferase], gene analysis, common variants) is a Medi-Cal benefit. A Treatment Authorization Request (TAR) is required when billing for the gene analysis. The TAR must document that the patient is undergoing thiopurine therapy and that the...

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MolDX Local Coverage Determination (LCD) Update

  • November 15, 2018

The MolDX: Genomic Health Oncotype DX Prostate Cancer Assay L36153 A/B MAC Local Coverage Determination (LCD) was revised. 

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MolDX Local Coverage Determination - Notice Period

  • November 15, 2018

Multiplex Nucleic Acid Amplified Tests for Respiratory Viral Panels L37713 began its notice period September 27, 2018. The notice period will end November 11, 2018. Any revisions made will become effective November 12, 2018.

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FDA Approves Myriad Genetics BRCA CDx with Pfizer’s Metastic Breast Cancer Drug

  • November 14, 2018

The US Food and Drug Administration has approved Myriad Genetics' BRACAnalysis CDx for determining which HER2-negative, metastatic breast cancer patients have inherited BRCA1 and BRCA2 genetic mutations and therefore may benefit from treatment with Pfizer's Talzenna (talazoparib).  The study showed that Talzenna-treated patients had a median...

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Luxembourg Cancer Institute Launches Precision Oncology Study

  • November 14, 2018

Luxembourg's Institut National du Cancer (INC) announced today that it has begun an initiative to evaluate the use of molecular diagnostics in cancer treatment. Called MDLUX2, the three-year program will use a standardized set of molecular diagnostics to analyze tissue samples from hundreds of cancer patients recruited through local hospitals....

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UK Plans to Sequence 5M Genomes in Next Five Years

  • November 14, 2018

From 2019 onward, the National Health Service will offer "all seriously ill children" whole-genome sequencing as part of their standard care, as well as to adults with certain rare diseases or "hard-to-treat" illnesses, the UK government said. In addition, patients will be asked to give consent for their genomic data to be analyzed in an effort to...

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Invitae, Alnylam to Provide Free Genetic Testing for Primary Hyperoxaluria

  • November 14, 2018

Invitae announced today that it is partnering with RNAi therapeutics firm Alnylam Pharmaceuticals to provide free genetic testing to improve diagnosis and management of a rare inherited disorder called primary hyperoxaluria. Genetic testing to gauge whether a person carries a mutation in the AGXT gene associated with the disease can confirm a...

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Baylor Gets $6.3M NCI Grant for Racial, Ethnic Cancer Disparities Work

  • November 14, 2018

The National Cancer Institute (NCI) has awarded $6.3 million to support researchers at Baylor College of Medicine in understanding the biological causes of racial and ethnic disparities in prostate and breast cancers.  Baylor will use the grant to establish the Minority Patient-derived xenograft Development and Trial Center (M-PDTC), which...

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