Billing and Coding: MolDx: SEPT9 Gene Test

MolDX determined that Septin 9 (SEPT9) methylation analysis (CPT 81327) for colorectal cancer detection is a statutorily excluded service and is not covered by Medicare; screening tests without signs or symptoms are not Medicare benefits and will be denied. Claims seeking a SEPT9 denial must include CPT 81327, append GY to indicate a statutorily excluded service (or GX if a voluntary ABN is used), and include the DEX Z‑Code Identifier in the specified claim comment/narrative fields or paper form locations.

"Septin 9 (SEPT9) methylation analysis for colorectal cancer detection (CPT 81327) is a statutorily excluded service and is not a Medicare covered benefit."

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