Billing and Coding: MolDX: Prometheus® IBD sgi Diagnostic® Policy

This billing/coding guidance complements LCD L37260 for the Prometheus IBD sgi Diagnostic test and specifies claim submission requirements: select the appropriate CPT code and report 1 unit of service. ABN is not required for statutorily excluded services (use modifier GY to indicate exclusion and GX for voluntary ABN), and DEX Z-Code identifiers must be entered adjacent to the CPT on specified Part A and Part B electronic and paper claim fields.

"Select and report the applicable CPT code for the Prometheus IBD sgi Diagnostic test on the claim."

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