Z86.001 — Personal history of in-situ neoplasm of cervix uteri
ICD-10-CM
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Documentation Required
- Select and report the appropriate CPT code for the laboratory-developed test.
- Enter 1 unit of service (UOS) for the claim.
- For Part B electronic professional claims (837P), place the appropriate DEX Z-Code identifier adjacent to the CPT code in Loop 2400 or SV101-7; for Part B paper claims, place it in Box 19.
- For Part A electronic institutional claims (837I), place the appropriate DEX Z-Code identifier adjacent to the CPT code in Line SV202-7; for UB04 paper claims, place it in Block 80.
Key Coverage Criteria
- Lab-developed tests for inherited cancer syndromes in patients with cancer (per LCD L38966) are covered when billed with the required claim elements specified in this policy.
- Coverage applies for lab-developed tests (LDTs) for inherited cancer syndromes in patients with cancer when billed in accordance with MolDX LCD L38972.
- Lab-developed tests for inherited cancer syndromes in patients with cancer are billed per this guidance and the referenced LCD L38974.
- Lab-developed tests for inherited cancer syndromes in patients with cancer as described in Local Coverage Determination (LCD) L39040 are the services addressed by this billing/coding guidance.
- There is a clinical indication for germline (inherited) testing for hereditary cancer.
- Patient has one or more risk factors for germline (inherited) hereditary cancer.
10 Active Policies
A58756 — Billing and Coding: MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer
J05
L39040 — MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer
J05
A58681 — Billing and Coding: MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer
A58734 — Billing and Coding: MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer
Related Codes
Have a follow-up question?
Ask Verity about documentation requirements, denial risks, or coverage in your state.