Billing and Coding: MolDx: BCR-ABL

For dates of service on/after 4/15/2013, multiple BCR-ABL breakpoint tests assigned a single test ID (including NGS translocation analysis) should be billed using CPT 81479 with one unit of service and the assigned DEX Z-code; FDA-approved MRDx BCR-ABL is billed with CPT 0040U, and ABL1 kinase domain mutation analysis with CPT 81170 plus one UOS and DEX Z-code. CPT codes 81206, 81207, and 81208 are only reportable when performed as a single test or as the specified combinations; labs must place the DEX Z-code adjacent to the CPT code in the specified claim fields (SV101-7, SV202-7, NTE, Loop 2400, Box 19, Line SV202-7, Block 80).

"Report multiple BCR-ABL breakpoint tests assigned a single test ID using CPT 81479 (one unit of service) when tests are performed as a panel or combination."

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