Billing and Coding: MolDX: bioTheranostics Cancer TYPE ID® Update

Billing for the Cancer TYPE ID RT‑PCR 92‑gene assay requires placement of the assigned DEX Z-code identifier adjacent to the CPT code on the claim and reporting an appropriate ICD‑10‑CM diagnosis code. Specific claim-field locations are mandated (Part B: Loop 2400/SV101‑7 for 837P or Item 19 for paper; Part A: Line SV202‑7 for 837I or Block 80 for UB04) and the Days/Unit field must be '1'; MolDX requires the test be ordered only by the treating physician.

"Cancer TYPE ID (RT-PCR 92-gene assay) test may be billed when claim includes the required DEX Z-code identifier adjacent to the CPT code and appropriate ICD-10-CM diagnosis code."

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