Billing and Coding: MolDX: SULT4A1 Genetic Testing

SULT4A1 genetic testing (single-gene or panels containing SULT4A1) is a statutorily excluded service and is not a Medicare benefit; MolDX will deny such tests. To receive a denial, bill with CPT 81479 and follow required claim reporting: ABN is not required (use GX if voluntarily issued; use GY to indicate statutorily excluded), supply DEX Z-Code identifiers adjacent to CPT codes, and use the specified SV101-7/SV202-7, NTE, and claim form fields for Part A and Part B submissions.

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

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