Billing and Coding: MolDX: BluePrint® Test

The BluePrint® test is statutorily excluded from Medicare coverage because evidence of clinical utility is insufficient, so it is not covered. To document and receive a service denial, bill using CPT 81479, append GY to indicate statutory exclusion (append GX only if a voluntary ABN is issued), and include the DEX Z‑Code adjacent to the CPT code in the specified claim fields (Part B 837P Loop 2400/SV101-7 or Item 19; Part A 837I SV202-7 or UB04 Block 80).

"The BluePrint® test is statutorily excluded from Medicare coverage due to insufficient evidence of required clinical utility."

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