Billing and Coding: MolDX: SEPT9 Gene Test

Noridian considers SEPT9 (Septin 9 methylation analysis, CPT 81327) for colorectal cancer screening a statutorily excluded service and will deny it under Medicare; screening in the absence of signs or symptoms is not a Medicare benefit. Claims should include CPT 81327 and appropriate coding identifiers: append GY to indicate statutory exclusion (GX if voluntary ABN issued), and include the DEX Z-Code adjacent to the CPT code in the specified Part A/Part B claim fields.

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

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