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    • Forms
      • Technical Assessment Submissions Checklist (GEN-CQD-003)
      • Technical Assessment (TA) Summary Form (GEN-PF-001)
      • Analytical Validity, Clinical Validation Summary Worksheet, NGS Solid Tumors (NGS-PF-004)
      • Analytical Validity, Clinical Validation Summary Worksheet, Myeloid Malignancies (NGS-PF-005)
      • Analytical Validity, Clinical Validation Summary Worksheet, Inherited Cancer Testing (GER-PF-006)
      • Analytical Validity, Performance Specifications for Comprehensive Genomic Profiling Checklist, Somatic (NGS-PF-002)
      • Analytical Validity, Clinical Validity Summary Worksheet, MRD (MRD-PF-016)
      • Analytical Validity, Clinical Validation Summary Worksheet, Molecular Risk Stratification (MRS-PF-020)
      • Analytical Validity, Clinical Validation Summary Worksheet, Syndromic Infectious Disease Panels (MID-PF-019)
      • Analytical Validity, Clinical Validation Summary Worksheet, Inherited Germline Testing for Non-Cancer (GER-PF-008)
      • Analytical Validity, Clinical Validation Summary Worksheet, Venous Thromboembolism Risk and Hereditary Thrombophilia (GER-PF-023)
      • Analytical Validity, Clinical Validation Summary Worksheet, Whole Exome or Whole Genome Sequencing (GER-PF-024)
      • Analytical Validity, Clinical Validation Summary Worksheet, Prenatal cell-free DNA Screening (PCFS-PF-021)
      • Analytical Validity, Clinical Validation Summary Worksheet, Prenatal Carrier Screening (PCS-PF-022)
      • Pharmacogenomics Submission Form (PGX-PF-007)
      • Technical Assessment Submission Checklist and Questionnaire for Solid Organ Allograft Rejection (ALLO-CQ-003)
      • Allograft Rejection Performance (ALLO-PF-009)
      • Gapfill Worksheet (GEN-PF-010)
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    {"DID":"crit1cbe5b","Sites":"DEX","Start Date":"12-19-2022 08:16","End Date":"12-26-2022 20:17","Content":"DEX Customer Service will be closed on December 23 and 26, 2022, in observance of the Christmas holiday.","URL":"","Target":null,"Color":"green","Mode":"Standard\n","Priority":"yes"}, {"DID":"crit2a411c","Sites":"DEX","Start Date":"09-02-2022 07:32","End Date":"09-05-2022 20:32","Content":"DEX Customer Service will be closed on September 5, 2022, in observance of Labor Day.","URL":"","Target":"_self","Color":"green","Mode":"Standard\n","Priority":"yes"}, {"DID":"crit2aebb2","Sites":"DEX","Start Date":"12-29-2023 14:07","End Date":"01-01-2024 22:07","Content":"DEX Customer Service will be closed on January 1, 2024, in observance of New Year's Day.","URL":"","Target":"_self","Color":"green","Mode":"Standard\n","Priority":"no"}, {"DID":"crit2eb32b","Sites":"DEX","Start Date":"06-01-2022 00:47","End Date":"06-30-2022 19:00","Content":"Attention: Please take a look at the Top News update for important information for Medicare Advantage Payors fourth wave.","URL":"https://www.dexzcodes.com/palmetto/dex.nsf/DID/07860YUDBI","Target":"_self","Color":"blue","Mode":"Standard\n","Priority":null}, {"DID":"crit431d3a","Sites":"DEX^MolDx","Start Date":"08-30-2024 00:33","End Date":"09-02-2024 22:00","Content":"DEX Customer Service will be closed on September 2, 2024, in observance of Labor Day.","URL":"","Target":"_self","Color":"blue","Mode":"Standard\n","Priority":"no"}, {"DID":"crit4ca1be","Sites":"DEX^MolDx","Start Date":"12-20-2023 08:00","End Date":"12-26-2023 18:00","Content":"The Palmetto GBA MolDX Program will be closed on December 25 and 26, 2023, in observance of the Christmas holiday.","URL":"","Target":null,"Color":"green","Mode":"Standard\n","Priority":"no"}, {"DID":"crit5ab234","Sites":"DEX","Start Date":"12-19-2024 08:00","End Date":"12-25-2024 18:00","Content":"DEX Customer Service will be closed on December 24 and 25, 2024, in observance of the Christmas holiday.","URL":"","Target":null,"Color":"green","Mode":"Standard\n","Priority":"no"}, {"DID":"crit5b4b5e","Sites":"DEX^MolDx","Start Date":"12-20-2023 08:00","End Date":"12-26-2023 18:00","Content":"DEX Customer Service will be closed on December 25 and 26, 2023, in observance of the Christmas holiday.","URL":"","Target":null,"Color":"green","Mode":"Standard\n","Priority":"no"}, {"DID":"crita2453e","Sites":"DEX","Start Date":"11-21-2022 08:16","End Date":"11-25-2022 20:17","Content":"DEX Customer Service will be closed on November 24 and 25, 2022, in observance of the Thanksgiving holiday.","URL":"","Target":null,"Color":"green","Mode":"Standard\n","Priority":"yes"}, {"DID":"crita5deeb","Sites":"DEX","Start Date":"06-30-2023 07:32","End Date":"07-04-2023 20:32","Content":"DEX Customer Service will be closed on July 4, 2023, in observance of Independence Day.","URL":"","Target":"_self","Color":"green","Mode":"Standard\n","Priority":"yes"}, {"DID":"critaa1a25","Sites":"DEX","Start Date":"11-25-2024 11:58","End Date":"11-29-2024 19:00","Content":"DEX Customer Service will be closed on November 28 and 29, 2024, in observance of the Thanksgiving holiday.","URL":"","Target":"_self","Color":"green","Mode":"Standard\n","Priority":"no"}, {"DID":"critbbaeec","Sites":"DEX","Start Date":"05-26-2023 12:40","End Date":"05-29-2023 21:47","Content":"DEX Customer Service will be closed on May 29, 2023, in observance of Memorial Day.","URL":"","Target":"_self","Color":"green","Mode":"Standard\n","Priority":"yes"}, {"DID":"critbc15cb","Sites":"DEX","Start Date":"05-24-2024 08:00","End Date":"05-27-2024 18:00","Content":"DEX Customer Service will be closed on May 27, 2024, in observance of Memorial Day.","URL":"","Target":null,"Color":"blue","Mode":"Standard\n","Priority":"no"}, {"DID":"critbece1d","Sites":"DEX","Start Date":"01-13-2023 08:00","End Date":"01-16-2023 17:30","Content":"DEX Customer Service will be closed on January 16, 2023, in observance of Martin Luther King Jr. Day.","URL":"","Target":"_self","Color":"green","Mode":"Standard\n","Priority":"yes"}, {"DID":"critc2c553","Sites":"DEX","Start Date":"05-24-2024 08:00","End Date":"05-27-2024 18:00","Content":"The Palmetto GBA MolDX Program will be closed on May 27, 2024, in observance of Memorial Day.","URL":"","Target":"_self","Color":"blue","Mode":"Standard\n","Priority":"no"}, {"DID":"crite2be25","Sites":"DEX","Start Date":"08-23-2022 09:53","End Date":"08-29-2022 09:00","Content":"Palmetto GBA will be performing a system upgrade on the DEX (TM) Registry Thursday, August 25th at 5pm ET through Monday, August 29th at approximately 8am ET. For any questions, please contact DEX.customer.service@palmettogba.com","URL":"","Target":"_self","Color":"yellow","Mode":"Standard\n","Priority":"yes"}, {"DID":"criteca5c4","Sites":"DEX^MolDx","Start Date":"11-21-2023 09:17","End Date":"11-24-2023 18:00","Content":"The Palmetto GBA MolDX Program will be closed on November 23 and 24, 2023, in observance of the Thanksgiving holiday.","URL":"","Target":null,"Color":"green","Mode":"Standard\n","Priority":"no"}
    1. DEX
    2. Forms
    3. Form Finder
    • Technical Assessment Submissions Checklist (GEN-CQD-003)
    • Technical Assessment (TA) Summary Form (GEN-PF-001)
    • Analytical Validity, Clinical Validation Summary Worksheet, NGS Solid Tumors (NGS-PF-004)
    • Analytical Validity, Clinical Validation Summary Worksheet, Myeloid Malignancies (NGS-PF-005)
    • Analytical Validity, Clinical Validation Summary Worksheet, Inherited Cancer Testing (GER-PF-006)
    • Analytical Validity, Performance Specifications for Comprehensive Genomic Profiling Checklist, Somatic (NGS-PF-002)
    • Analytical Validity, Clinical Validity Summary Worksheet, MRD (MRD-PF-016)
    • Analytical Validity, Clinical Validation Summary Worksheet, Molecular Risk Stratification (MRS-PF-020)
    • Analytical Validity, Clinical Validation Summary Worksheet, Syndromic Infectious Disease Panels (MID-PF-019)
    • Analytical Validity, Clinical Validation Summary Worksheet, Inherited Germline Testing for Non-Cancer (GER-PF-008)
    • Analytical Validity, Clinical Validation Summary Worksheet, Venous Thromboembolism Risk and Hereditary Thrombophilia (GER-PF-023)
    • Analytical Validity, Clinical Validation Summary Worksheet, Whole Exome or Whole Genome Sequencing (GER-PF-024)
    • Analytical Validity, Clinical Validation Summary Worksheet, Prenatal cell-free DNA Screening (PCFS-PF-021)
    • Analytical Validity, Clinical Validation Summary Worksheet, Prenatal Carrier Screening (PCS-PF-022)
    • Pharmacogenomics Submission Form (PGX-PF-007)
    • Technical Assessment Submission Checklist and Questionnaire for Solid Organ Allograft Rejection (ALLO-CQ-003)
    • Allograft Rejection Performance (ALLO-PF-009)
    • Gapfill Worksheet (GEN-PF-010)

    Licenses & Notices

    End User Point and Click Agreement

    CPT codes, descriptions and other data only are copyright 2012 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS Clauses Apply.

    You, your employees, and agents are authorized to use CPT only as contained in the following authorized materials (web pages, PDF documents, Excel documents, Word documents, text files, Power Point presentations and/or any Flash media) internally within your organization within the United States for the sole use by yourself, employees, and agents. Use is limited to use in Medicare, Medicaid, or other programs administered by the Centers for Medicare & Medicaid Services (CMS). You agree to take all necessary steps to insure that your employees and agents abide by the terms of this agreement.

    Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. License to use CPT for any use not authorized herein must be obtained through the AMA, CPT Intellectual Property Services, 515 N. State Street, Chicago, IL 60610. Applications are available at the AMA Web site, http://www.ama-assn.org/go/cpt .

    Applicable FARS/DFARS restrictions apply to government use.

    U.S. Government Rights

    This product includes CPT which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the American Medical Association, 515 North State Street, Chicago, Illinois, 60610. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2)(June 1995) and/or subject to the restrictions of DFARS 227.7202-1(a)(June 1995) and DFARS 227.7202-3(a)(June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department Federal procurements.

    AMA Disclaimer of Warranties and Liabilities

    CPT is provided “as is” without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. The AMA warrants that due to the nature of CPT, it does not manipulate or process dates, therefore there is no Year 2000 issue with CPT. The AMA disclaims responsibility for any errors in CPT that may arise as a result of CPT being used in conjunction with any software and/or hardware system that is not Year 2000 compliant. No fee schedules, basic unit, relative values or related listings are included in CPT. The AMA does not directly or indirectly practice medicine or dispense medical services. The responsibility for the content of this file/product is with Palmetto GBA or CMS and no endorsement by the AMA is intended or implied. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. This Agreement will terminate upon notice if you violate its terms. The AMA is a third party beneficiary to this Agreement.

    CMS Disclaimer

    The scope of this license is determined by the AMA, the copyright holder. Any questions pertaining to the license or use of the CPT must be addressed to the AMA. End Users do not act for or on behalf of CMS. THE CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CPT. THE CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL CONTAINED ON THIS PAGE. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information or material.

    Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by clicking below on the button labeled “I Accept.”

    LICENSE FOR USE OF “DENTAL PROCEDURE CODES” (CPT) FOURTH EDITION

    End User Point and Click Agreement

    The license granted herein is expressly conditioned upon your acceptance of all terms and conditions contained in this agreement. By clicking below on the button labeled “I accept”, you hereby acknowledge that you have read, understood and agreed to all terms and conditions set forth in this agreement.

    If you do not agree with all terms and conditions set forth herein, click below on the button labeled “I do not accept” and exit from this computer screen.

    If you are acting on behalf of an organization, you represent that you are authorized to act on behalf of such organization and that your acceptance of the terms of this agreement creates a legally enforceable obligation of the organization. As used herein, “you” and “your” refer to you and any organization on behalf of which you are acting.

    1. Subject to the terms and conditions contained in this Agreement, you, your employees and agentsa re authorized to use CDT only as contained in the following authorized materials and solely for internal use by yourself, employees and agents within your organization within the United States and its territories. Use of CDT is limited to use in programs administered by Centers for Medicare & Medicaid Services (CMS). You agree to take all necessary steps to ensure that your employees and agents abide by the terms of this agreement. You acknowledge that the ADA holds all copyright, trademark and other rights in CDT. You shall not remove, alter, or obscure any ADA copyright notices or other proprietary rights notices included in the materials.
    2. Any use not authorized herein is prohibited, including by way of illustration and not by way oflimitation, making copies of CDT for resale and/or license, transferring copies of CDT to any partynot bound by this agreement, creating any modified or derivative work of CDT, or making anycommercial use of CDT. License to use CDT for any use not authorized herein must be obtainedthrough the American Dental Association, 211 East Chicago Avenue, Chicago, IL 60611.Applications are available at the American Dental Association web site, http://www.ADA.org.
    3. Applicable Federal Acquisition Regulation Clauses (FARS)/Department of Defense FederalAcquisition Regulation supplement (DFARS) Restrictions Apply to Government Use. Please click here to see all U.S. Government Rights Provisions. 
    4. Organizations who contract with CMS acknowledge that they may have a commercial CDT license with the ADA, and that use of CDT codes as permitted herein for the administration of CMS programs does not extend to any other programs or services the organization may administer and royalties dues for the use of the CDT codes are governed by their commercial license.
    5. ADA DISCLAIMER OF WARRANTIES AND LIABILITIES. CDT is provided “as is” without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. No fee schedules, basic unit, relative values or related listings are included in CDT. The ADA does not directly or indirectly practice medicine or dispense dental services. The sole responsibility for software, including any CDT and other content contained therein, is with (insert name of applicable entity) or the CMS; and no endorsement by the ADA is intended or implied. The ADA expressly disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. This Agreement will terminate upon notice to you if you violate the terms of this Agreement.
      The ADA is a third party beneficiary to this Agreement.
    6. CMS DISCLAIMER. The scope of this license is determined by the ADA, the copyright holder. Any questions pertaining to the license or use of the CDT should be addressed to the ADA. End Users do not act for or on behalf of the CMS. CMS disclaims responsibility for any liability attributable to end user use of the CDT. CMS will not be liable for any claims attributable to any errors, omissions, or other inaccuracies in the information or material covered by this license. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information or material.

    The license granted herein is expressly conditioned upon your acceptance of all terms and conditions contained in this agreement. If the foregoing terms and conditions are acceptable to you, please indicate your agreement by clicking below on the button labeled “I Accept”. If you do not agree to the terms and conditions, you may not access or use software. Instead you must click below on the button labeled “I DO NOT ACCEPT” and exit from this computer screen.

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    Licenses & Agreements

    End User Point and Click Agreement

    CPT codes, descriptions and other data only are copyright 2012 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS Clauses Apply.

    You, your employees, and agents are authorized to use CPT only as contained in the following authorized materials (web pages, PDF documents, Excel documents, Word documents, text files, Power Point presentations and/or any Flash media) internally within your organization within the United States for the sole use by yourself, employees, and agents. Use is limited to use in programs administered by Palmetto GBA. You agree to take all necessary steps to insure that your employees and agents abide by the terms of this agreement.

    Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. License to use CPT for any use not authorized herein must be obtained through the AMA, CPT Intellectual Property Services, 515 N. State Street, Chicago, IL 60610. Applications are available at the AMA Web site, http://www.ama-assn.org/go/cpt .

    Applicable FARS/DFARS restrictions apply to government use.

    U.S. Government Rights

    This product includes CPT which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the American Medical Association, 515 North State Street, Chicago, Illinois, 60610. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2)(June 1995) and/or subject to the restrictions of DFARS 227.7202-1(a)(June 1995) and DFARS 227.7202-3(a)(June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department Federal procurements.

    AMA Disclaimer of Warranties and Liabilities

    CPT is provided “as is” without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. The AMA warrants that due to the nature of CPT, it does not manipulate or process dates, therefore there is no Year 2000 issue with CPT. The AMA disclaims responsibility for any errors in CPT that may arise as a result of CPT being used in conjunction with any software and/or hardware system that is not Year 2000 compliant. No fee schedules, basic unit, relative values or related listings are included in CPT. The AMA does not directly or indirectly practice medicine or dispense medical services. The responsibility for the content of this file/product is with Palmetto GBA and no endorsement by the AMA is intended or implied. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. This Agreement will terminate upon notice if you violate its terms. The AMA is a third party beneficiary to this Agreement.

    The license granted herein is expressly conditioned upon your acceptance of all terms and conditions contained in this agreement. If the foregoing terms and conditions are acceptable to you, please indicate your agreement by clicking below on the button labeled “I ACCEPT”. If you do not agree to the terms and conditions, you may not access or use the software. Instead, you must click below on the button labeled “I DO NOT ACCEPT” and exit from this computer screen.

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