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Billing and Coding: MolDX: Predictive Classifiers for Early Stage Non-Small Cell Lung Cancer
A57112
Wisconsin Physicians Service Insurance Corporation (J05)
Effective: February 24, 2022
Updated: December 31, 2025
See LCD L38443Policy Summary
This billing and coding guidance states that predictive classifier tests for early-stage non-small cell lung cancer are covered when performed in accordance with LCD MolDX L38443. Claims must report the appropriate CPT code, 1 unit of service, the DEX Z-Code adjacent to the CPT code in specified Part A/Part B claim fields, and an appropriate ICD-10-CM diagnosis code.
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Key requirements from the full policy
"Predictive classifier tests for early-stage non-small cell lung cancer are covered when performed in accordance with LCD MolDX: Predictive Classifiers for Early Stage Non-Small Cell Lung Cancer (L3..."
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