Billing and Coding: MolDX: SEPT9 Gene Test

MolDX considers the SEPT9 (CPT 81327) Septin 9 methylation analysis for colorectal cancer detection a statutorily excluded service and Medicare does not cover it; claims for this test will be denied. Asymptomatic screening is not a Medicare benefit, and an ABN is not required for statutorily excluded services. To document a denial, submit CPT 81327, append modifier GY (GX if a voluntary ABN), and include the DEX Z-Code in the specified claim comment/narrative fields.

"SEPT9 (Septin 9) promoter methylation analysis (CPT 81327) for colorectal cancer detection is not a Medicare-covered service and will be denied as a statutorily excluded service."

Sign up to see full coverage criteria, indications, and limitations.