Billing and Coding: MolDX: Prostate Cancer Genomic Classifier Assay for Men with Localized Disease

This billing/coding guidance requires claims for the Prostate Cancer Genomic Classifier Assay (for men with localized prostate cancer) be submitted with the appropriate CPT code, diagnosis code ICD-10-CM C61, and exactly 1 unit of service. The DEX Z-Code™ identifier must be placed adjacent to the CPT code in specified comment/narrative fields depending on Part A/Part B and electronic/paper claim type (detailed claim-field locations provided).

"Prostate genomic classifier assay is for men with localized prostate cancer and should be billed with diagnosis code ICD-10-CM C61 (malignant neoplasm of prostate)."

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