Billing and Coding: MolDX: BCR-ABL

This billing guideline directs that multiple BCR-ABL1 breakpoint tests assigned a single test ID should be billed using CPT 81479 (for NGS BCR-ABL translocation analysis use CPT 81479 plus one UOS and the assigned DEX Z-code). The FDA-approved MRDx BCR-ABL test is reported with CPT 0040U, and ABL1 kinase domain mutation analysis for acquired imatinib resistance is reported with CPT 81170 plus one UOS and the assigned DEX Z-code; CPT 81206/81207/81208 may only be reported when performed as a single test. The policy is effective for dates of service on or after 2013-04-15 and refers to MolDX multiple-gene testing guidance (A57503) for additional billing rules.

"CPT codes 81206, 81207, and 81208 may only be reported when the respective assay is performed as a single test (not separately billed as component tests)."

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