2023/24 National Genomic Test Directory released in England

In April 2023, NHS England published an updated version of the National Genomic Test Directory for 2023/2024, which lists tests commissioned by NHS England via Genomic Laboratory Hubs. Three documents were published specifying tests codes, clinical indications, target genes, the technology by which tests are available, and eligibility criteria for patients:

• National Genomic Test Directory for cancer (version 6);
• National Genomic Test Directory for rare and inherited diseases (version 5);
• Rare and inherited disease eligibility criteria (version 5).

Sixteen new codes (test-indication combinations) were introduced in the Test Directory for cancer. Some examples of the newly added codes are provided below:

• M220.7 FGFR2 rearrangement FISH for cholangiocarcinoma;
• M22.10 MYB rearrangement FISH/RT-PCR for diffuse astrocytoma (pediatric);
• M93.6 Multi-target NGS panel-small variant (BTK, PLCG2, RAS, MAP2K1, BCL2) for lymphoma;
• M181.5 Ig gene hypermutation detection NGS for hairy-cell leukemia non-classical variant;
• M117.19 High Sensitivity BRAF for histiocytosis.

A total of 25 new codes (test-indication combinations) were added for rare and inherited diseases. Some examples of new codes are provided below:

• R430.2 Exon level CNV (copy number variations) detection by MLPA (Multiplex ligation-dependent probe amplification) or equivalent (BRCA1, BRCA2, MLH1, MSH2, MSH6, ATM, PALB2, CHEK2) for inherited prostate cancer;
• R440.2 Hereditary Diabetes Insipidus exon-level CNV detection by MLPA or equivalent (AVP; AVPR2; AQP2);
• R15.5   Primary immunodeficiency or monogenic inflammatory bowel disease WES (whole exome sequencing);
• R436.1 Hereditary alpha tryptasaemia targeted variant testing (TPSAB1);       
• R441.1 Unexplained death in infancy and sudden unexplained death in childhood WGS  (whole genome sequencing).

See the full details here.

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