Billing and Coding: MolDX: BluePrint® Test

The MolDX assessment found insufficient evidence of clinical utility for the BluePrint® molecular subtyping assay, making it statutorily excluded and not covered by Medicare. To obtain a denial, submit the service as CPT 81479 and indicate statutory exclusion by appending modifier GY (use GX only for a voluntary ABN); include the DEX Z-Code identifier adjacent to the CPT code in the specified Part A and Part B claim fields.

"The BluePrint® molecular subtyping assay is statutorily excluded from Medicare coverage and is not a covered service due to insufficient evidence of clinical utility."

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