Billing and Coding: MolDX: Oncotype DX® Breast Cancer Assay

Oncotype DX Breast is indicated for ER-positive invasive breast cancer that is node-negative, has micrometastases, or involves 1–3 positive nodes. Billing requires Days/Unit=1, reporting the appropriate ICD-10-CM code, and including the Z-Code Identifier in specified Part A/Part B claim fields; DCIS (Oncotype DX DCIS Score) is excluded and must not share the same Z-Code Identifier.

"Oncotype DX Breast is covered for patients with estrogen-receptor positive (ER+) invasive breast carcinoma that is node-negative (no regional lymph node metastasis)."

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