Molecular and Genomic Testing Procedure Codes
The procedure codes listed below are subject to Medical Necessity Determination review as part of our Molecular and Genomic Testing Program. This listing was last revised on February 27, 2023 and may be subject to change.
- 0001U
- 0002M
- 0003M
- 0004M
- 0005U
- 0006M
- 0007M
- 0011M
- 0012M
- 0013M
- 0012U
- 0013U
- 0014U
- 0016M
- 0018U
- 0019U
- 0022U
- 0026U
- 0029U
- 0030U
- 0031U
- 0032U
- 0033U
- 0034U
- 0036U
- 0037U
- 0045U
- 0047U
- 0048U
- 0050U
- 0053U
- 0055U
- 0056U
- 0060U
- 0067U
- 0069U
- 0070U
- 0071U
- 0072U
- 0073U
- 0074U
- 0075U
- 0076U
- 0078U
- 0079U
- 0084U
- 0087U
- 0088U
- 0089U
- 0090U
- 0094U
- 0101U
- 0102U
- 0103U
- 0111U
- 0113U
- 0114U
- 0118U
- 0120U
- 0129U
- 0130U
- 0131U
- 0132U
- 0133U
- 0134U
- 0135U
- 0136U
- 0137U
- 0138U
- 0153U
- 0156U
- 0157U
- 0158U
- 0159U
- 0160U
- 0161U
- 0162U
- 0169U
- 0170U
- 0171U
- 0172U
- 0173U
- 0175U
- 0179U
- 0203U
- 0204U
- 0205U
- 0208U
- 0209U
- 0211U
- 0212U
- 0213U
- 0214U
- 0215U
- 0216U
- 0217U
- 0218U
- 0220U
- 0228U
- 0229U
- 0230U
- 0231U
- 0232U
- 0233U
- 0234U
- 0235U
- 0236U
- 0237U
- 0238U
- 0239U
- 0242U
- 0244U
- 0245U
- 0246U
- 0250U
- 0252U
- 0253U
- 0254U
- 0258U
- 0260U
- 0262U
- 0264U
- 0265U
- 0266U
- 0267U
- 0268U
- 0269U
- 0270U
- 0271U
- 0272U
- 0273U
- 0274U
- 0276U
- 0277U
- 0278U
- 0282U
- 0285U
- 0286U
- 0287U
- 0288U
- 0289U
- 0290U
- 0291U
- 0292U
- 0293U
- 0294U
- 0296U
- 0297U
- 0298U
- 0299U
- 0300U
- 0306U
- 0307U
- 0313U
- 0314U
- 0315U
- 0317U
- 0318U
- 0319U
- 0320U
- 0326U
- 0329U
- 0331U
- 0332U
- 0333U
- 0334U
- 0335U
- 0336U
- 0339U
- 0340U
- 0341U
- 0343U
- 0345U
- 0347U
- 0348U
- 0349U
- 0350U
- 0355U
- 0356U
- 0362U
- 0363U
- 0364U
- 0368U
- 0379U
- 0380U
- 0386U
- 81162
- 81163
- 81164
- 81165
- 81166
- 81167
- 81173
- 81174
- 81185
- 81186
- 81189
- 81190
- 81201
- 81202
- 81203
- 81212
- 81215
- 81216
- 81217
- 81221
- 81222
- 81223
- 81225
- 81226
- 81227
- 81228
- 81229
- 81230
- 81231
- 81232
- 81238
- 81248
- 81249
- 81252
- 81253
- 81257
- 81258
- 81259
- 81269
- 81277
- 81283
- 81286
- 81289
- 81291
- 81292
- 81293
- 81294
- 81295
- 81296
- 81297
- 81298
- 81299
- 81300
- 81302
- 81303
- 81304
- 81306
- 81307
- 81308
- 81313
- 81317
- 81318
- 81319
- 81321
- 81322
- 81323
- 81325
- 81326
- 81327
- 81328
- 81335
- 81336
- 81337
- 81346
- 81349
- 81350
- 81351
- 81353
- 81355
- 81361
- 81362
- 81363
- 81364
- 81400
- 81406
- 81407
- 81408
- 81410
- 81411
- 81412
- 81413
- 81414
- 81415
- 81416
- 81417
- 81418
- 81419
- 81422
- 81425
- 81426
- 81427
- 81430
- 81431
- 81432
- 81433
- 81434
- 81435
- 81436
- 81437
- 81438
- 81439
- 81440
- 81441
- 81442
- 81443
- 81445
- 81448
- 81449
- 81450
- 81451
- 81455
- 81456
- 81460
- 81465
- 81470
- 81471
- 81479
- 81490
- 81493
- 81500
- 81503
- 81504
- 81518
- 81519
- 81520
- 81521
- 81522
- 81523
- 81525
- 81529
- 81535
- 81536
- 81538
- 81539
- 81540
- 81541
- 81542
- 81546
- 81551
- 81552
- 81554
- 81595
- 81596
- 81599
- G0327
- G9143
- S3800
- S3840
- S3841
- S3842
- S3844
- S3845
- S3846
- S3850
- S3852
- S3854
- S3861
- S3865
- S3866
- S3870
Recent Changes
- For services to be provided on and after April 1, 2023, eviCore will also perform MND of the services represented by procedure codes 0364U, 0368U, 0379U, 0380U and 0386U.
- For services to be provided on and after January 18, 2023, eviCore will also perform MND of the services represented by procedure codes 0355U, 0356U, 0362U, 0363U, 81418, 81441, 81449, 81451 and 81456.
- eviCore will no longer perform MND of the services represented by 84999 for January 1, 2023 and after. With the expansion of the Molecular Pathology CPT code set, the billing of 84999 for molecular assays is no longer appropriate or necessary.
- For services to be provided on and after October 1, 2022, eviCore will also perform MND of the services represented by 0332U, 0333U, 0334U, 0335U, 0336U, 0339U, 0340U, 0341U, 0343U, 0345U, 0347U, 0348U, 0349U and 0350U.
- For services to be provided on and after August 31, 2022, eviCore will also perform MND of the services represented by 0326U, 0329U and 0331U.
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