Billing and Coding: MolDX: MGMT Promoter Methylation Analysis

This billing/coding guidance requires reporting MGMT Promoter Methylation Analysis with CPT 81287 and 1 unit of service, using Bill Type Code 022x for Medicare Part B skilled nursing inpatient claims where applicable. Claim submissions must include the appropriate DEX Z‑Code identifier adjacent to the CPT code in the specified electronic or paper claim fields (Part B: 837P Loop 2400/SV101-7 or Box 19; Part A: 837I Line SV202-7 or UB04 Block 80) and must report an appropriate ICD-10-CM diagnosis code.

"MGMT Promoter Methylation Analysis (CPT 81287) is reportable when coverage criteria of MolDX LCD L35974 are met."

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