Billing and Coding: MolDX: SULT4A1 Genetic Testing

SULT4A1 genetic testing (single-gene tests and panels including SULT4A1) is not covered by Medicare and is statutorily excluded; MolDX will deny such tests. To obtain a denial, submit claims using CPT 81479 and follow the specified claim submission instructions including use of GY (statutorily excluded) or GX (voluntary ABN) modifiers and placement of the DEX Z-Code and service lines in the designated SV101-7/SV202-7/Item 19/Block 80 claim fields.

"SULT4A1 genetic testing is not a Medicare benefit and is a statutorily excluded service."

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