Billing and Coding: MolDX: PIK3CA Gene Tests

PIK3CA targeted gene sequencing is billed and coded for patients who are postmenopausal women or men with HR-positive, HER2-negative advanced/metastatic breast cancer and a PIK3CA mutation after progression on endocrine therapy. Coverage is effective for dates of service on or after 2019-05-24, and testing to support Piqray therapy should reflect detection by an FDA‑approved test; claims must include the appropriate CPT, diagnosis, and the DEX Z-Code™ identifier in the specified claim fields.

"PIK3CA targeted gene sequencing is covered for postmenopausal women and men with hormone receptor (HR)-positive, HER2-negative, advanced or metastatic breast cancer who have a PIK3CA mutation and h..."

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