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Billing and Coding: MolDX: SULT4A1 Genetic Testing
A55210
Wisconsin Physicians Service Insurance Corporation (J05)
Effective: February 1, 2024
Updated: December 31, 2025
Policy Summary
SULT4A1 genetic testing is not covered by Medicare and is statutorily excluded, including single‑gene tests and panels that include SULT4A1. To obtain a formal denial, submit the claim using CPT 81479 and follow billing instructions (use GY to indicate statutorily excluded, GX for voluntary ABN, provide DEX Z‑Code adjacent to the CPT, and use SV101-7/SV202-7 or NTE as applicable).
Coverage Criteria Preview
Key requirements from the full policy
"SULT4A1 genetic testing (single-gene) is a statutorily excluded service and is not a Medicare benefit."
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