Billing and Coding: MolDX: SEPT9 Gene Test

Noridian considers the SEPT9 (Septin 9 methylation analysis; CPT 81327) test for colorectal cancer screening to be a statutorily excluded service and not Medicare-covered, so such claims will be denied. Screening tests performed without signs or symptoms are not Medicare benefits. Billing guidance: submit CPT 81327, append GY to indicate exclusion (GX if voluntary ABN issued), and include the DEX Z-Code in the specified claim comment/narrative fields.

"Septin 9 methylation analysis (SEPT9; CPT 81327) for colorectal cancer detection is not a Medicare-covered service and is statutorily excluded."

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