Billing and Coding: MolDX: Short Tandem Repeat (STR) Markers and Chimerism (CPT® codes 81265-81268)

MolDX covers STR/chimerism testing (CPT 81265–81268) for recipient/donor identification and for post-transplant monitoring of engraftment or disease recurrence; twin zygosity testing is statutorily excluded. CPT 81265 is generally a one-time (once-per-lifetime) pre-transplant recipient/donor test reported as 1 unit of service, CPT 81266 is allowed for additional double-cord samples in bone marrow transplants, CPT 81267 is for post-transplant pre/post comparisons, and CPT 81268 is for buccal/germline recipient specimens; billing and DEX Z-Code documentation requirements must be followed and exceptions to limits require appeal.

"Chimerism analysis to identify appropriate donors and to monitor engraftment success or disease recurrence is a covered Medicare service."

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