Specialty Genetic Testing CPT.xlsx

XLSX spreadsheet 27 KB Posted Jan 6, 2021

Attached to: Q301--Specialty Genomic Reference Laboratory Testing Services (STX)
Solicitation number: 36C25721Q0294
Issued by: Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 17

About this file

Written by GovTribe AI · Dec 28, 2023

This document combines a solicitation for specialty genetic reference laboratory testing services with a related federal contract opportunity notice. The solicitation requests quotes for specialty genetic testing services listed in an attached CPT code sheet. Required services include flow cytometry, cytogenetics, fluorescence in situ hybridization (FISH), anatomic pathology, molecular pathology, and liquid biopsy tests. Quotes are due by January 14, 2021 for services for the South Texas Veterans Healthcare System Laboratory. The opportunity notice provides additional context, specifying this is solicitation number 36C25721Q0294 from the Department of Veterans Affairs Veterans Health Administration VISN 17 for a one year contract with option years to provide the referenced testing services. Evaluation criteria, solicitation provisions and clauses, and additional terms are provided.

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File	Type	Posted
Wage Determination 15-5253.pdf	PDF	Jan 6, 2021
36C25721Q0294_1.docx	DOCX document	Jan 6, 2021
36C25721Q0294.pdf	PDF	Jan 6, 2021

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Sheet1

		Estimated Annual Quantities (Base Year) - A
	REF	Test Name	CPTS	Estimated Quanity	Self-Perform (in-house)?
Yes / No	Name of Lab Performing Test	CLIA Certificate Number of Lab Performing Test	Amount
	10 Color Flow Cytometry
	AA	Technical Component Up to 24 markers	88184, 88185	10
	AB	Additional Marker >24 (per Markers)	88185	10
	AC	Flow Interpretation	88187, 88188, 88189	10
	10 Color Flow Cytometry Special Pricing
	AD	Flow Profile PNH Tech(8)	88184, 88185	10
	AF	Flow Profile DNA Global	88182	10
	AE	Special Flow Profiles	No CPTs available	10
	CYTOGENETICS
	AF	Chromosome Analysis	88237 or 88233 or 88230 or 88235 or 88239, +88261 or 88262 or 88264, +88280, +88285	35
	AG	Additional Karyotypes	88280	35
	AH	Additional Cells	88285	35
	AI	Additional Culture	88237 or 88239	35
	AJ	No Growth	No CPT Code	35
	AK	Chromosome Analysis Interpretation	88291	35
	FISH
	AL	FISH Manual-Tech only (Initial Single Probe Staining Procedure)	88368TC	350
	AM	FISH Manual-Interpretation(Initial Single Probe Staining Procedure)	88368PC	350
	AN	FISH Manual-Global(Initial Single Probe Staining Procedure)	88368	350
	AO
	AP	FISH Manual- Tech only (Additional Single Probe Staining Procedure)	88369TC	5
	AQ	FISH Manual-Interpretation(Additional Single Probe Staining Procedure)	88369PC	5
	AR	FISH Manual-Global(Additional Single Probe Staining Procedure)	88369	5
	AS
	AT	FISH Manual-Tech only (Each Multiplex Probe Staining Procedure)	88377TC	5
	AU	FISH Manual-Interpretation(Each Multiplex Probe Staining Procedure)	88377PC	5
	AV	FISH Manual-Global(Each Multiplex Probe Staining Procedure)	88377	5
	AW
		FISH Automated-Tech (Initial Single Probe Staining Procedure)	88367TC	5
	AZ	FISH Automated-Interpretation(Initial Single Probe Staining Procedure)	88367PC	5
	AY	FISH Automated-Global(Initial Single Probe Staining Procedure)	88367	5
	AZ
		FISH Automated-Tech only (Additional Single Probe Staining Procedure)	88373TC	5
	BA	FISH Automated-Interpretation(Additional Single Probe Staining Procedure)	88373PC	5
	BB	FISH Automated-Global(Additional Single Probe Staining Procedure)	88373	5

BC	FISH Automated-Tech only (Each Multiplex Probe Staining Procedure)	88374TC	5
BD	FISH Automated-Interpretation(Each Multiplex Probe Staining Procedure)	88374PC	5
BE	FISH Automated-Global(Each Multiplex Probe Staining Procedure)	88374	5
BF
	Manual Bladder, Cancer FISH
	Bladder Cancer FISH Tech(4 probes)-Manual Read	882120TC	5
BG	Bladder Cancer FISH Interpretation(4 probes)-Manual Read	88120PC	5
BH	Bladder Cancer FISH Global(4 probes)-Manual Read	88120	5
	Automated Bladder, Cancer FISH
BI	Bladder Cancer FISH Tech(4 probes)-Auto Read	88121TC	5
BJ	Bladder Cancer FISH Interpretation(4 probes)-Auto Read	88121PC	5
BK	Bladder Cancer FISH Global(4 probes)-Auto Read	88121	5
	Anatomic Pathology
BL	Blood Smear Interpretation	85060	5
BM	Bone Marrow Interpretation	85097	5
BP	Surgical Pathology	88305	5
BQ	Surgical Pathology Tech	88305TC	5
BR	Decalcification	88311	5
BS	Decalcification Tech	88311TC	5
BT	Special Stain	88312	5
BU	Special Stain Tech	88312TC	5
BV	Tissue Special Stain	88313	5
BW	Tissue Special Stain Tech	88313TC	5
BX	Histo/Cytochemistry to ID Enzyme	88314	5
BY	Histo/Cytochemistry to ID Enzyme Tech	88314TC	5
BZ	Cytochemistry	88319	5
CA	Cytochemistry Tech	88319TC	5
CB	Consult	88321	5
CC	Professional Consult	88323	5
CD	Professional Consult Tech	88323TC	5
CE	Comprehensive Consult	88325	5
CF	IHC Qualitative;addn'l stain procedure	88341	5
CG	IHC Qualitative;addn'l stain procedure Tech	88341TC	5
CH	IHC Qualitative; per specimen; Initial Single antibody strain	88342	400
CI	IHC Qualitative; per specimen; Initial Single antibody strain tech	88342TC	400
CJ	IHC Qualitative; per specimen; multiplex antibody stain	88344	400
CK	IHC Qualitative; per specimen; multiplex antibody stain tech	88344TC	400
CL	PD-L1(KEYTRUDA, OPDIVO, TECENTRIZ, Glo	88360	50
CM	PD-L1(KEYTRUDA, OPDIVO, TECENTRIZ, Tech	88360TC	50
CN	IHC Quantitative	88360	10
CO	IHC Quantitative tech	88360TC	10
CP	IHC Morphometric Analysis; computer assist, Glo	88361	10
CQ	IHC Morphometric Analysis; computer assist, Tech	88361TC	10
CR	Cytopathology, Selective Cellular Enhancement, Global	88112	10
CS	Cytopathology, Selective Cellular Enhancement	88112TC	10
CT	IHC by ISH	88365/ 88364	10
CU	IHC by ISH TC	88365TC/ 88364TC	10
CV	HPV ISH	88365/ 88364	10
CW	HPV ISH, Tech	88365TC/ 88364TC	10
	Molecular Pathology
CX	ABL Kinase Domain Mutation Analysis(Bi-directional Sequencing)	81170	5
CY	Androgen Receptor Mutation Analysis	81204	5
CZ	ALL Fusion Profile	81450	5
	ALK Mutation Analysis	81479	5
Db	ASXL1 Mutation Analysis	81175	5
DB	ATRX Mutation Analysis	81479	5
DC	BCR-ABL1 Standard p210, p190	81479	300
DD	Quantitative BCR/ABL, t(9:22) Major(p210) for CML	81206	5
DE	Quantitative BCR/ABL, t(9:22) Minor(p210) for ALL	81207	5
DF	BCR ABL1 Non Standard p230	81208	300
DG	B-Cell Gene Rearrangement(Fragment Length Analysis)	81479	30
DH	B-Cell Gene Rearrangement-IGH	81261	30
DI	B-Cell Gene Rearrangement-IGK	81264	30
DJ	T-Cell Receptor Beta Gene Rearrangement	81340	25
DK	T-Cell Receptor Gamma Gene Rearrangement	81342	25
DL	B&T Cell Gene Rearrangement(Fragment Length Analysis)	81479	5
DM	B-Cell Gene Rearrangement IGH	81261	5
DN	B-Cell Gene Rearrangement-IGK	81264	5
DO	T-Cell Receptor Gamma Gene Rearrangement	81342	5
DP	BCL-1 Translocation t(11:14)	81401	5
DQ	BCL-2 Translocation t(14:18)	81401	5
DR	BRCA1/2 Mutation &Del/Dup Analysis	81162	5
	BRCA1/2 Mutation Analysis for Tumors	81163
DS	BRCA 1 Mutation & Del/Dup Analysis	81166	5
DT	BRCA 2 Mutation & Del/Dup Analysis	81167	5
DU	BRAF Mutation Analysis(Bi-directional Sequencing)	81210	25
	THxID BRAF Mutation Analysis by PCR for Melanoma	81210	25
DV	KRAS Mutation Analysis(Bi-Directional Sequencing)	81275	25
DX	BTK Mutation Analysis(Single Gene Assay)	81233	5
DY	BTK Inhibitor Acquired Resistance Panel	81479	5
DZ	BTK Inhibitor Primary Susceptibility Panel	81479	5
EA	CALR Mutation Analysis	81219	5
EB	CARD11 Mutation Analysis	81479	5
EE	CEBPA Mutation Analysis(Bi-directional Sequencing)	81218	5
EF	KIT(c-KIT) Mutation Analysis	81272	5
EH	CSF3R Mutation Analysis	81479	5
EI	CX CR4 Mutation Analysis (Bi-directional Sequencing)	81479	5
	DNA Fingerprinting Analysis	81265 or 81266	5
EJ	DNMT3A Mutation Analysis (Bi-directional Sequencing)	81403	5
EK	EGFR Mutation Analysis(Bi-directional Sequencing)	81235	20
EL	EGFR VIII Analysis	81479	5
EM	EGFR T790M Germline Mutation Analysis	81235	5
EP	ETV6-RUNX1 (TEL-AML1) Translocation, t(12;21)	81401	5
	FGFR CDx Molecular Analysis by PCR	0154U	25
ER	FLT3 (ITD & TKD) Mutation Analysis	81479	5
ES	FLT3 (incl D385)Mutation Analysis(Bi-directional Seq & Fragment Length)	81245	5
ET	FLT3 (incl D385)Mutation Analysis(Bi-directional Seq & Fragment Length)	81246	5
EV	Hereditary Cancer Comprehensive Panel	81432	5
EZ	HPV DNA Tissue Testing	87624	5
FA	HRAS Mutation Analysis(Bi-directional Sequencing)	81403	5
FC	IDH1 and IDH2 Mutations Analysis(Bi-directional Sequencing)	81479	5
FD	IgH Clonality/MRD by NGS	81263	5
FE	IgVH Mutation Analysis	81263	5
FG	inv(16) CVFB-MYH11 Translocation	81401	5
	InVisionFirst - Lung Liquid Biopsy	81479	10
FH	JAK2 V617F Mutation Analysis	81270	125
FI	JAK2 Exon 12-14 Mutation Analysis (Bi-directional Seq)	81403	5
FJ	JAK2 V617F with reflex to Exon 12-14 Mutation Analysis (Bi-directional Seq)	81270, 81403	5
FK	Lynch Syndrome (include EPCAM, MLH1, MSH2, MSH6, PMS2)	81445	5
	MAP2K1 Mutation Analysis	81406	5
FL	MET Exon 14 Deletion Analysis	81479	5
FM	MGMT Promoter Methylation Analysis	81287	5
FN	Microsatellite Instability Analysis(Fragment Length Analysis)	81301	15
FP	MLH1 Promoter Methylation Analysis	81288	5
	MLL-PTD Analysis	81479	5
FQ	MPL Mutation Analysis (Bi-directional Sequencing)	81402	5
FU	MPL Mutation Analysis(Bi-directional Sequencing)	81402	20
FV	MPN Extended Reflex Panel	81479	95
FW	JAK2 Exon 12-14 Mutation Analysis (Bi-directional Seq)	81403	5
FX	JAK2 V617F Mutation Analysis	81270	125
FY	CALR Mutation Analysis	81219	95
GB	MYD88 Mutation Analysis	81479	5
	Lung NGS Fusion Profile	81445	10
	NexCouse Complete	81455	5
GE	NGS Comprehensive Sarcoma Fusion Profile	81479	5
GF	NGS Ewing Sarcoma Fusion Profile	81479	5
GG	NGS Non-Ewing Sarcoma Fusion Profile	81479	5
GH	NGS Pediatric Sarcoma Fusion Profile	81479	5
GI	NGS Rhabdomyosarcoma Fusion Profile	81479	5
	NTRK NGS Fusion Profile	81479	5
	NTRK & RET NGS Fusion Profile	81479	5
GK	NOTCH1 Mutation Analysis	81407	5
GL	NPM1 MRD Analysis (Fragment Length Analysis)	81310	5
GM	NRAS Mutation Analysis	81310	25
GN	PDGFRa Mutation Analysis	81314	25
GO	PIK3CA Mutation Analysis (bi-Directional sequencing)	81314	5
GP	PLC-Gamma-2 Mutation Analysis	81320	5
GQ	PML-RARA Translocation, t(15;17)	81315	10
	Prosigna Breast Cancer Prognostic Gene Signature	81520	5
	Rapid AML Therapeutic Panel	81479	5
GW	RAS/RAF Panel	81479	5
GZ	RUNX1-RUNX1T1 (AML1-ETO)Translocation, t(8;21)	81401	5
HB	SF3B1 Mutation Analysis (Bi-Directional Sequencing)	81479	5
HC	SRSF2 Mutation Analysis( Bi-Directional Sequencing)	81479	5
HD	STAT3 Mutation Analysis	81405	5
HE	TERT Promoter Mutation Analysis	81345	5
HF	TET2 Mutation Analysis	81479	5
HG	TP53 Mutation Analysis	81405	10
HK	UGT1A1 Genotyping	81350	5
	NEOTYPE(Molecular)
	Hematologic
HO	NeoType AITL/Peripheral T-Cell Lymphoma Profile	81479	10
HQ	NeoType AML Prognostic Profile	81450	20
HR	NeoType CLL Prognostic Profile	81479	10
HS	NeoType JMML Profile	81450	10
HT	NeoType Lymphoma Profile	81450	10
HU	NeoType MDS/CMML Profile	81450	10
HW	NeoType Myeloid Disorders Profile	81450	10
	Solid Tumor Profiles
HX	NeoType Brain Tumor Profile	81479	2
HY	NeoType Breast Tumor Profile	81445	5
HZ	NeoType Cervical Tumor Profile	81479	5
IA	NeoType Colorectal Tumor Profile	81445	5
IB	NeoType Endometrial Tumor Profile	81479	5
IC	NeoType Esophageal Tumor Profile	81445	5
ID	NEoType Gastric Tumor Profile	81445	5
IE	NeoType GI Predictive Profile	81479	5
IF	NeoType GIST/Soft Tissue Profile	81479	5
IG	NeoType Head & Neck Tumor Profile	81479	5
	NeoType HRD+Profile	81445	5
IH	NeoType Liposarcoma Fusion Profile	81479	5
II	NeoType Liver/Biliary Tumor Profile	81479	5
IJ	NEoType Lung Tumor Profile	81479	5
IK	NeoType Melanoma	81479	5
IL	NeoType Other Solid Tumor Profile	81479	5
IM	NeoType Ovarian Tumor Profile	81479	5
IN	NeoType Pancreas Tumor Profile	81479	5
IP	NeoType Precision Profile for Solid Tumor	81479	5
IQ	NeoType Thyroid Profile	81479	5
	NeoTYpe Discovery Profile For Solid Tumors	81479	5
IR	NeoArray SNP/Cytogenetic Profile	81229	5
	NeoType (Global)
	Hematologic Profiles
IT	NeoType AITL/Peripheral T-Cell Lymphoma Profile	81479	5
	NeoType AML Prognostic Profile	81450	5
IV	NeoType CLL Prognostic Profile	81479, 88374x4	5
IW	NeoType JMML Profile	81450	5
IX	NeoType Lymphoma Profile	81450	5
IY	NeoType MDS/CMML Profile	81450	5
JA	NeoType Myeloid Disorders Profile	81450	5
	Solid Tumor Profiles
JB	NeoType Brain Tumor Profile	81479, 88377x6, 88360	2
JC	NeoType Breast Tumor Profile	81479, 88377x2, 88360, 88342	5
JD	NeoType Cervical Tumor Profile	81479, 88377x2, 88360, 88342	5
JE	NeoType Colorectal Tumor Profile	81479, 88377x2, 88360, 88342	5
JF	NeoType Endometrial Tumor Profile	81479, 88377x2, 88360, 88342	5
JG	NeoType Esophageal Tumor Profile	81479, 88377x2, 88360, 88342	5
JH	NEoType Gastric Tumor Profile	81479, 88377x2, 88342	5
JI	NeoType GI Predictive Profile	81479, 88374, 88360, 88342	5
JJ	NeoType GIST / Soft Tissue Profile	81479, 88377x2, 88360	5
JK	NeoType Head & Neck Tumor Profile	81479, 88377x2, 88360, 88342	5
JL	NeoType Liposarcoma Fusion Profile	81479, 88374 OR 88377, 88342	5
JM	NeoType Liver/Biliary Tumor Profile	81479, 88377x2, 88360, 88342	5
JN	NEoType Lung Tumor Profile	81479, 88374, 88377x5, 88360, 88342	5
JO	NeoType Melanoma Profile	81479, 88377, 88360, 88342	5
JP	NeoType Other Solid Tumor Profile	81479, 88377x2, 88360, 88342	5
JQ	NeoType Ovarian Tumor Profile	81479, 88377x2, 88360, 88342	5
JR	NeoType Pancreas Tumor Profile	81479, 88377x3, 88360, 88342	5
JT	NeoType Precision Profile for Solid Tumor	81479, 88360, 88342	5
JU	NeoType Thyroid Profile	81479, 88377x2, 88360, 88342	5
JV	NeoTYpe Discovery Profile For Solid Tumors	81479, 88374, 88377x8, 88360, 88342	5
JW	NeoArray SNP/Cytogenetic Profile	81229	5
	NeoType Technical Only
	Hematologic Profiles
JY	NeoType AITL/Peripheral T-Cell Lymphoma Profile	81479	5
KA	NeoType AML Prognostic Profile	81450	5
KB	NeoType CLL Prognostic Profile	81479, 88374TC	5
KC	NeoType JMML Profile	81450	5
KD	NeoType Lymphoma Profile	81450	5
KE	NeoType MDS/CMML Profile	81450	5
KG	NeoType Myeloid Disorders Profile	81450	5
	Solid Tumor Profiles
KH	NeoType Brain Tumor Profile	81479, 88377TCx7, 88360TC	5
KI	NeoType Breast Tumor Profile	81479, 88377TCX2, 88360TC, 88342TC	5
KJ	NeoType Cervical Tumor Profile	81479, 88377TCX2, 88360TC, 88342TC	5
KK	NeoType Colorectal Tumor Profile	81479, 88377TCX2, 88360TC, 88342TC	5
KL	NeoType Endometrial Tumor Profile	81479, 88377TCX2, 88360TC, 88342TC	5
KM	NeoType Esophageal Tumor Profile	81479, 88377TCX2, 88360TC, 88342TC	5
KN	NeoType Gastric Tumor Profile	81479, 88377TCX2, 88360TC, 88342TC	5
KO	NeoType GI Predictive Profile	81479, 88374TC, 88360TC, 88342TC	5
KP	NeoType GIST/ Soft Tissue Profile	81479,88377TCx2,88360TC	5
KQ	NeoType Head & Neck Tumor Profile	81479, 88377TCX2, 88360TC, 88342TC	5
KR	NeoType Liposarcoma Fusion Profile	81479, 88374TC OR 88377TC, 88342TC	5
KS	NeoType Liver/Biliary Tumor Profile	81479, 88377TCx2, 88360TC, 88342TC	5
KT	NEoType Lung Tumor Profile	81479,88374TC,88377TCX5,88360TC,88342TC	5
KU	NeoType Melanoma Profile	81479, 88377TC, 88360TC, 88342TC	5
KV	NeoType Other Solid Tumor Profile	81479, 88377TCX2, 88360TC, 88342TC	5
KW	NeoType Ovarian Tumor Profile	81479, 88377TCX2, 88360TC, 88342TC	5
KX	NeoType Pancreas Tumor Profile	81479, 88377TCX3, 88360TC, 88342TC	5
KZ	NeoType Precision Profile for Solid Tumor	81479, 88360TC, 88342TC	5
LA	NeoType Thyroid Profile	81479, 88377TCx2, 88360TC, 88342TC	5
LB	NeoTYpe Discovery Profile For Solid Tumors	81479, 88374TC, 88377TCx8, 88360TC, 88342TC	5
LC	NeoArray SNP/Cytogenetic Profile	81229	5
	NeoLAB Liquid Biopsy
LE	NeoLab AML-Profile Liquid Biopsy	81450	5
LF	NeoLab BTK Inhibitor Acquired Resistance Panel Liquid Biopsy	81479	5
LG	NeoLab c-kit Mutation Analysis-Liquid Biopsy	81272	5
LH	NeoLab EGFR T790M-Liquid Biopsy	81235	5
LI	NeoLab FLT3 Mutation Analysis-Liquid Biopsy	81479	5
LJ	NeoLab IDH1 Mutation Analysis-Liquid Biopsy	81120	5
LK	NeoLab IDH2 Mutation Analysis-Liquid Biopsy	81121	5
LM	NeoLab inv(16) CBFB-MYH11 Translocation-Liquid Biopsy	81401	5
LN	NeoLab KRAS Mutation Analysis-Liquid Biopsy	81479	5
LO	NeoLab MDS/CMML Profile-Liquid Biopsy	81450	5
LP	NeoLab Myeloid Disorders Profile-Liquid Biopsy	81450	5
LQ	NeoLab NPM1 Mutation Analysis-Liquid Biopsy	81310	5
LR	NeoLab NRAS Mutation Analysis-Liquid biopsy	81311	5
LS	NeoLab PML-RARA Translocation-Liquid Biopsy	81315	5
LU	NeoLab RUNX1-RNX1T1 Translocation-Liquid Biopsy	81401	5
LV	NeoLab Solid Tumor Monitor-Liquid Biopsy	81445	5
	Flow Cytometry
LW	Refrigerate and Hold	No CPT Code Available	20
LX	Freeze and Hold	No CPT Code Available	20
	Cytogenetics
LY	Culture and Hold	No CPT Code Available	20
	FISH
LZ	Direct Harvest and Hold for FISH	No CPT Code Available	20
	Molecular Testing
MA	Freeze and Hold	No CPT Code Available	20
MB	Extract Nucleic Acid and Hold	No CPT Code Available	20

South Texas Veterans Healthcare System &"-,Bold"&14SOURCES SOUGHT Specialty Genetic Reference Lab Testing Services

&"-,Bold Italic"Exhibit A 3C25721Q0090 &"-,Bold Italic"Page &P of &N

File details come from the government source that posted it. Updated Jan 6, 2021.