Billing and Coding: MolDX: SULT4A1 Genetic Testing

SULT4A1 genetic testing, whether single-gene or as part of a panel, is statutorily excluded and not a Medicare benefit and will be denied. Claims to document denials should use CPT 81479 with the appropriate DEX Z-Code and append modifier GY to indicate the statutorily excluded service (use GX for a voluntarily issued ABN); ABNs are not required for excluded services.

"SULT4A1 genetic testing (single-gene) is not a Medicare benefit and is a statutorily excluded service."

Sign up to see full coverage criteria, indications, and limitations.