Billing and Coding: MolDX: Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy (ARVD/C) Testing

Genetic testing for ARVD/C (commonly performed as a multi-gene panel; CPT 81439) is statutorily excluded and not covered for services on or after February 7, 2013. Claims seeking a formal denial should include CPT 81439, append modifier GY for statutorily excluded services (use GX only if a voluntary ABN is issued), and place the DEX Z-Code identifier adjacent to the CPT in the specified Part A/Part B claim fields.

"Genetic testing for Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy (ARVD/C), including multi-gene panels for RYR2, TMEM43, DSP, PKP2, DSG2, DSC2, and JUP (CPT 81439), is statutorily excl..."

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