Billing and Coding: MolDX: BluePrint® Test

MolDX determined the BluePrint® molecular subtyping assay is statutorily excluded from Medicare coverage due to insufficient evidence of clinical utility, so Medicare will not cover the test. Claims for BluePrint should be submitted using CPT 81479, must include DEX Z-Code identifiers in the specified Part A/B comment fields, and should append the GY modifier to indicate a statutorily excluded service; ABNs are not required but a voluntary ABN may be appended with modifier GX.

"The BluePrint® molecular subtyping assay is statutorily excluded from Medicare coverage because there is insufficient evidence of required clinical utility."

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