Access PDF reference guides for Medicare region J5 WPS local coverage determination lists below.
Policies for Medicare Region J5 WPS
Iowa, Kansas, Missouri, and Nebraska are included under this policy. Jurisdiction is determined by the state in which your performing Quest lab is located.
Below, you’ll find a list of Medicare Coverage Policies for tests or test groups applicable to your state. Diagnosis codes are required for all Medicare orders to document medical necessity.
Click on the links below to find the associated diagnosis codes and frequency information within the policy for the test you want to order. Some links will provide a concise Medicare Coverage and Coding Guide for the coverage policy, while others will direct you to the CMS website policy page.
- National Coverage Guides
- Non-Covered ICD-10 Codes
- Local Reference Guides
- Local CMS Policies
Find links to PDF Reference Guides for Medicare National Coverage Determination Lists below.
Collagen Crosslinks, Any Method
Digoxin Therapeutic Drug Assay
Glycated Hemoglobin/Glycated Protein
Hepatitis Panel/Acute Hepatitis Panel
Human Immunodeficiency Virus (HIV) Testing (Prognosis Including Monitoring)
Human Immunodeficiency Virus (HIV) Testing (Diagnosis)
Lymphocyte Mitogen Response Assays
Next Generation Sequencing (NGS)
Partial Thromboplastin Time (PTT)
Tumor Antigen by Immunoassay CA 15-3/CA 27.29
Tumor Antigen by Immunoassay CA 19-9
Non-covered ICD-10 codes apply to all lab National Coverage Determinations. See the PDF Reference Guide here.
Access links to CMS Site Policies for Medicare region J5 WPS below.
Genetic Testing for CYP2C19, CYP2D6, CYP2C9, and VKORC1
Molecular Diagnostic Testing (L34762) Retired 02 15 2017
MolDX: Biomarkers in Cardiovascular Risk Assessment
MolDX: BRCA1 and BRCA2 Genetic Testing
MolDX: Breast Cancer Assay: Prosigna
MolDX: Breast Cancer Index℠ Genetic Assay
MolDX: Chromosome 1p/19q Deletion Analysis
MolDX-CDD: Decipher® Prostate Cancer Classifier Assay
MolDX-CDD: NSCLC, Comprehensive Genomic Profile Testing
MolDX-CDD: Prolaris™ Prostate Cancer Genomic Assay
MolDX: GeneSight® Assay for Refractory Depression
MolDX: Genetic Testing for BCR-ABL Negative Myeloproliferative Disease
MolDX: Genetic Testing for Lynch Syndrome
MolDX: HLA-B*15:02 Genetic Testing
For more information about how Quest can help you streamline your practice, download our Medicare coverage brochure.
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Medicare coverage & coding guides
Medicare coverage & coding guides
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