Billing and Coding: MolDX: MammaPrint

MammaPrint is a genomic diagnostic test for FFPE breast cancer tissue to assess risk of distant metastasis and is validated for early‑stage breast cancer (MINDACT). Billing requires placement of the appropriate DEX Z‑Code adjacent to the CPT code (for NGS use CPT 81523 on/after 2022-01-01) and specific claim field entries; only one assay type may be performed per date of service and, in bilateral disease, the test is generally allowed up to twice per patient lifetime with further occurrences requiring appeal and supporting documentation.

"MammaPrint is indicated to analyze the gene expression profile of FFPE breast cancer tissue to assess a patient's risk for distant metastasis."

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