About this policy
The information in this article contains billing, coding or other guidelines that complement the Local Coverage Determination (LCD) for MolDX: Repeat Germline Testing L38274.
Codes in this policy
Code numbers and each code’s status as the policy records it. CPT code descriptions are left out of this page, as are the passages that cite CPT codes; the official document has them.
| Code | Code system | Status in this policy |
|---|---|---|
| 0001U | HCPCS | Covered |
| 0004M | HCPCS | Covered |
| 0029U | HCPCS | Covered |
| 0030U | HCPCS | Covered |
| 0031U | HCPCS | Covered |
| 0032U | HCPCS | Covered |
| 0034U | HCPCS | Covered |
| 0070U | HCPCS | Covered |
| 0071U | HCPCS | Covered |
| 0072U | HCPCS | Covered |
| 0073U | HCPCS | Covered |
| 0074U | HCPCS | Covered |
| 0075U | HCPCS | Covered |
| 0076U | HCPCS | Covered |
| 0079U | HCPCS | Covered |
| 0084U | HCPCS | Covered |
| 0094U | HCPCS | Covered |
| 0101U | HCPCS | Covered |
| 0102U | HCPCS | Covered |
| 0103U | HCPCS | Covered |
| 0129U | HCPCS | Covered |
| 0130U | HCPCS | Covered |
| 0133U | HCPCS | Covered |
| 0134U | HCPCS | Covered |
| 0136U | HCPCS | Covered |
| 0137U | HCPCS | Covered |
| 0138U | HCPCS | Covered |
| 0156U | HCPCS | Covered |
| 0157U | HCPCS | Covered |
| 0158U | HCPCS | Covered |
| 0159U | HCPCS | Covered |
| 0160U | HCPCS | Covered |
| 0161U | HCPCS | Covered |
| 0162U | HCPCS | Covered |
| 0169U | HCPCS | Covered |
| 0170U | HCPCS | Covered |
| 0173U | HCPCS | Covered |
| 0175U | HCPCS | Covered |
| 0180U | HCPCS | Covered |
| 0181U | HCPCS | Covered |
| 0182U | HCPCS | Covered |
| 0183U | HCPCS | Covered |
| 0184U | HCPCS | Covered |
| 0185U | HCPCS | Covered |
| 0186U | HCPCS | Covered |
| 0187U | HCPCS | Covered |
| 0188U | HCPCS | Covered |
| 0189U | HCPCS | Covered |
| 0190U | HCPCS | Covered |
| 0191U | HCPCS | Covered |
| 0192U | HCPCS | Covered |
| 0193U | HCPCS | Covered |
| 0194U | HCPCS | Covered |
| 0195U | HCPCS | Covered |
| 0196U | HCPCS | Covered |
| 0197U | HCPCS | Covered |
| 0198U | HCPCS | Covered |
| 0199U | HCPCS | Covered |
| 0200U | HCPCS | Covered |
| 0201U | HCPCS | Covered |
| 0203U | HCPCS | Covered |
| 0205U | HCPCS | Covered |
| 0209U | HCPCS | Covered |
| 0212U | HCPCS | Covered |
| 0213U | HCPCS | Covered |
| 0214U | HCPCS | Covered |
| 0215U | HCPCS | Covered |
| 0216U | HCPCS | Covered |
| 0217U | HCPCS | Covered |
| 0218U | HCPCS | Covered |
| 0221U | HCPCS | Covered |
| 0222U | HCPCS | Covered |
| 0230U | HCPCS | Covered |
| 0231U | HCPCS | Covered |
| 0232U | HCPCS | Covered |
| 0233U | HCPCS | Covered |
| 0234U | HCPCS | Covered |
| 0235U | HCPCS | Covered |
| 0236U | HCPCS | Covered |
| 0237U | HCPCS | Covered |
| 0238U | HCPCS | Covered |
| 0246U | HCPCS | Covered |
| 0258U | HCPCS | Covered |
| 0260U | HCPCS | Covered |
| 0264U | HCPCS | Covered |
| 0265U | HCPCS | Covered |
| 0266U | HCPCS | Covered |
| 0267U | HCPCS | Covered |
| 0268U | HCPCS | Covered |
| 0269U | HCPCS | Covered |
| 0270U | HCPCS | Covered |
| 0271U | HCPCS | Covered |
| 0272U | HCPCS | Covered |
| 0273U | HCPCS | Covered |
| 0274U | HCPCS | Covered |
| 0276U | HCPCS | Covered |
| 0277U | HCPCS | Covered |
| 0278U | HCPCS | Covered |
| 0282U | HCPCS | Covered |
| 0286U | HCPCS | Covered |
| 0289U | HCPCS | Covered |
| 0290U | HCPCS | Covered |
| 0291U | HCPCS | Covered |
| 0292U | HCPCS | Covered |
| 0293U | HCPCS | Covered |
| 0294U | HCPCS | Covered |
| 0318U | HCPCS | Covered |
| 0335U | HCPCS | Covered |
| 0345U | HCPCS | Covered |
| 0347U | HCPCS | Covered |
| 0348U | HCPCS | Covered |
| 0349U | HCPCS | Covered |
| 0350U | HCPCS | Covered |
| 0355U | HCPCS | Covered |
| 0378U | HCPCS | Covered |
| 0389U | HCPCS | Covered |
| 0392U | HCPCS | Covered |
| 0400U | HCPCS | Covered |
| 0401U | HCPCS | Covered |
| 0411U | HCPCS | Covered |
| 0417U | HCPCS | Covered |
| 0419U | HCPCS | Covered |
| 0425U | HCPCS | Covered |
| 0426U | HCPCS | Covered |
| 0439U | HCPCS | Covered |
| 0440U | HCPCS | Covered |
| 0449U | HCPCS | Covered |
| 0454U | HCPCS | Covered |
| 0460U | HCPCS | Covered |
| 0461U | HCPCS | Covered |
| 0474U | HCPCS | Covered |
| 0475U | HCPCS | Covered |
| 0476U | HCPCS | Covered |
| 0477U | HCPCS | Covered |
| 0500U | HCPCS | Covered |
| 0516U | HCPCS | Covered |
| 0529U | HCPCS | Covered |
| 0532U | HCPCS | Covered |
| 0533U | HCPCS | Covered |
| 0567U | HCPCS | Covered |
| 0582U | HCPCS | Covered |
| 0583U | HCPCS | Covered |
| 0605U | HCPCS | Covered |
| 81105 | HCPCS | Covered |
| 81106 | HCPCS | Covered |
| 81107 | HCPCS | Covered |
| 81108 | HCPCS | Covered |
| 81109 | HCPCS | Covered |
| 81110 | HCPCS | Covered |
| 81111 | HCPCS | Covered |
| 81112 | HCPCS | Covered |
| 81161 | HCPCS | Covered |
| 81162 | HCPCS | Covered |
| 81163 | HCPCS | Covered |
| 81164 | HCPCS | Covered |
| 81165 | HCPCS | Covered |
| 81166 | HCPCS | Covered |
| 81167 | HCPCS | Covered |
| 81171 | HCPCS | Covered |
| 81172 | HCPCS | Covered |
| 81173 | HCPCS | Covered |
| 81174 | HCPCS | Covered |
| 81177 | HCPCS | Covered |
| 81178 | HCPCS | Covered |
| 81179 | HCPCS | Covered |
| 81180 | HCPCS | Covered |
| 81181 | HCPCS | Covered |
| 81182 | HCPCS | Covered |
| 81183 | HCPCS | Covered |
| 81184 | HCPCS | Covered |
| 81185 | HCPCS | Covered |
| 81186 | HCPCS | Covered |
| 81187 | HCPCS | Covered |
| 81188 | HCPCS | Covered |
| 81189 | HCPCS | Covered |
| 81190 | HCPCS | Covered |
| 81200 | HCPCS | Covered |
| 81201 | HCPCS | Covered |
| 81202 | HCPCS | Covered |
| 81203 | HCPCS | Covered |
| 81204 | HCPCS | Covered |
| 81205 | HCPCS | Covered |
| 81209 | HCPCS | Covered |
| 81212 | HCPCS | Covered |
| 81215 | HCPCS | Covered |
| 81216 | HCPCS | Covered |
| 81217 | HCPCS | Covered |
| 81220 | HCPCS | Covered |
| 81221 | HCPCS | Covered |
| 81222 | HCPCS | Covered |
| 81223 | HCPCS | Covered |
| 81224 | HCPCS | Covered |
| 81225 | HCPCS | Covered |
| 81226 | HCPCS | Covered |
| 81227 | HCPCS | Covered |
| 81228 | HCPCS | Covered |
| 81229 | HCPCS | Covered |
| 81230 | HCPCS | Covered |
| 81231 | HCPCS | Covered |
| 81232 | HCPCS | Covered |
| 81233 | HCPCS | Covered |
| 81234 | HCPCS | Covered |
| 81238 | HCPCS | Covered |
| 81239 | HCPCS | Covered |
| 81240 | HCPCS | Covered |
| 81241 | HCPCS | Covered |
| 81242 | HCPCS | Covered |
| 81243 | HCPCS | Covered |
| 81244 | HCPCS | Covered |
| 81247 | HCPCS | Covered |
| 81248 | HCPCS | Covered |
| 81249 | HCPCS | Covered |
| 81250 | HCPCS | Covered |
| 81251 | HCPCS | Covered |
| 81252 | HCPCS | Covered |
| 81253 | HCPCS | Covered |
| 81254 | HCPCS | Covered |
| 81255 | HCPCS | Covered |
| 81256 | HCPCS | Covered |
| 81257 | HCPCS | Covered |
| 81258 | HCPCS | Covered |
| 81259 | HCPCS | Covered |
| 81260 | HCPCS | Covered |
| 81269 | HCPCS | Covered |
| 81271 | HCPCS | Covered |
| 81274 | HCPCS | Covered |
| 81283 | HCPCS | Covered |
| 81284 | HCPCS | Covered |
| 81285 | HCPCS | Covered |
| 81286 | HCPCS | Covered |
| 81289 | HCPCS | Covered |
| 81290 | HCPCS | Covered |
| 81291 | HCPCS | Covered |
| 81292 | HCPCS | Covered |
| 81293 | HCPCS | Covered |
| 81294 | HCPCS | Covered |
| 81295 | HCPCS | Covered |
| 81296 | HCPCS | Covered |
| 81297 | HCPCS | Covered |
| 81298 | HCPCS | Covered |
| 81299 | HCPCS | Covered |
| 81300 | HCPCS | Covered |
| 81302 | HCPCS | Covered |
| 81303 | HCPCS | Covered |
| 81304 | HCPCS | Covered |
| 81306 | HCPCS | Covered |
| 81307 | HCPCS | Covered |
| 81308 | HCPCS | Covered |
| 81309 | HCPCS | Covered |
| 81312 | HCPCS | Covered |
| 81317 | HCPCS | Covered |
| 81318 | HCPCS | Covered |
| 81319 | HCPCS | Covered |
| 81321 | HCPCS | Covered |
| 81322 | HCPCS | Covered |
| 81323 | HCPCS | Covered |
| 81324 | HCPCS | Covered |
| 81325 | HCPCS | Covered |
| 81326 | HCPCS | Covered |
| 81328 | HCPCS | Covered |
| 81329 | HCPCS | Covered |
| 81330 | HCPCS | Covered |
| 81331 | HCPCS | Covered |
| 81332 | HCPCS | Covered |
| 81333 | HCPCS | Covered |
| 81335 | HCPCS | Covered |
| 81336 | HCPCS | Covered |
| 81337 | HCPCS | Covered |
| 81343 | HCPCS | Covered |
| 81344 | HCPCS | Covered |
| 81346 | HCPCS | Covered |
| 81349 | HCPCS | Covered |
| 81350 | HCPCS | Covered |
| 81353 | HCPCS | Covered |
| 81354 | HCPCS | Covered |
| 81355 | HCPCS | Covered |
| 81361 | HCPCS | Covered |
| 81362 | HCPCS | Covered |
| 81363 | HCPCS | Covered |
| 81364 | HCPCS | Covered |
| 81374 | HCPCS | Covered |
| 81377 | HCPCS | Covered |
| 81381 | HCPCS | Covered |
| 81383 | HCPCS | Covered |
| 81410 | HCPCS | Covered |
| 81411 | HCPCS | Covered |
| 81412 | HCPCS | Covered |
| 81413 | HCPCS | Covered |
| 81414 | HCPCS | Covered |
| 81415 | HCPCS | Covered |
| 81418 | HCPCS | Covered |
| 81419 | HCPCS | Covered |
| 81425 | HCPCS | Covered |
| 81430 | HCPCS | Covered |
| 81431 | HCPCS | Covered |
| 81432 | HCPCS | Covered |
| 81434 | HCPCS | Covered |
| 81435 | HCPCS | Covered |
| 81437 | HCPCS | Covered |
| 81439 | HCPCS | Covered |
| 81440 | HCPCS | Covered |
| 81441 | HCPCS | Covered |
| 81442 | HCPCS | Covered |
| 81443 | HCPCS | Covered |
| 81448 | HCPCS | Covered |
| 81460 | HCPCS | Covered |
| 81465 | HCPCS | Covered |
| 81470 | HCPCS | Covered |
| 81471 | HCPCS | Covered |
| 81479 | HCPCS | Covered |
| 81493 | HCPCS | Covered |
| 81554 | HCPCS | Covered |