Billing and Coding: MolDX: FDA-Approved BRAF Tests
A54418
FDA-approved BRAF tests (cobas 4800 BRAF V600 and ThxID BRAF V600/K) are used to detect BRAF V600 mutations in melanoma to identify patients eligible for targeted therapies (vemurafenib for unresectable/metastatic disease; dabrafenib for V600E and trametinib for V600E/V600K). Billing requires CPT 81210 with the appropriate DEX Z-Code placed adjacent to the CPT code in specified claim fields (Part A and B) and selection of the correct ICD-10-CM diagnosis; all labs must register the test on DEX and confirm unmodified kit use. Coverage and billing are limited to FDA-approved indications and MolDX will apply NPI-to-test-ID editing and accept future FDA-approved amendments.
"Use the cobas 4800 BRAF V600 test to detect BRAF V600 mutations in patients with melanoma to determine eligibility for vemurafenib for unresectable or metastatic melanoma."
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