Billing and Coding: MolDX: Breast Cancer Index® (BCI) Gene Expression Test

MolDX covers the Breast Cancer Index (BCI) gene expression test for postmenopausal women with early-stage (T1-T3, pN0-pN1, M0) invasive breast carcinoma that is ER-positive and/or PR-positive and HER2-negative when results will guide chemotherapy and/or endocrine therapy. The test must use FFPE primary tumor tissue obtained prior to adjuvant treatment, is expected once per patient lifetime, and should be billed with CPT 81518 (1 unit) including the appropriate DEX Z-Code and ICD-10-CM diagnosis on the claim.

"Patient is postmenopausal."

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