Q79.63 — Vascular Ehlers-Danlos syndrome
ICD-10-CM
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Documentation Required
- Enter the appropriate DEX Z-Code identifier adjacent to the CPT code in the comment/narrative field for Part B electronic claims using Loop 2400 or SV101-7 (5010A1 837P).
- For Part B paper claims, enter the appropriate DEX Z-Code identifier adjacent to the CPT code in Box 19.
- For Part A electronic claims (837I), enter the appropriate DEX Z-Code identifier adjacent to the CPT code on Line SV202-7.
- For UB04 claims, enter the appropriate DEX Z-Code identifier adjacent to the CPT code in Block 80.
Key Coverage Criteria
- Genetic testing for heritable thoracic aortic disease is covered as defined by the MolDX Local Coverage Determination L39933.
- Genetic testing for heritable thoracic aortic disease as covered under MolDX LCD L39938.
- Genetic testing for heritable thoracic aortic disease when criteria of MolDX LCD L39944 are met.
- Genetic testing for heritable thoracic aortic disease is billed under this policy when consistent with the MolDX Local Coverage Determination L39946 and using one of the allowed CPT codes.
- Clinical indications for coverage follow the MolDX LCD L39989 (Genetic Testing in Heritable Thoracic Aortic Disease); this billing article does not define clinical eligibility.
- Covered only when the test has satisfactorily completed a MolDX Technical Assessment (TA).
15 Active Policies
A59908 — Billing and Coding: MolDX: Genetic Testing in Heritable Thoracic Aortic Disease
J05
L39989 — MolDX: Genetic Testing for Heritable Thoracic Aortic Disease
J05
A59847 — Billing and Coding: MolDX: Genetic Testing in Heritable Thoracic Aortic Disease
A59860 — Billing and Coding: MolDX: Genetic Testing in Heritable Thoracic Aortic Disease
A59868
Related Codes
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