Genomic technologies have revolutionized medicine in the post-genome era by offering the promise of personalized, precision healthcare based on DNA sequencing.1 Prior to and immediately after the completion of the human genome project, the primary bottleneck in advancing precision medicine was generating DNA sequencing and genetic variant data. With the advent of massively parallel sequencing technologies, the bottleneck shifted to clinically meaningful variant interpretation that is comprehensive, easily understandable, free from contradictory categorization, curated by experts, and freely available to the public. Guidelines developed by the American College of Medical Genetics and Genomics (ACMG) aid classification using a structured framework that defines 28 evidence codes by which to score a variant. There are 20 rules for combining codes to reach one of five conclusions that predict variant effect: pathogenic (P), likely pathogenic (LP), variant of uncertain significance (VUS), likely benign (LB), or benign (B).2, 3