Billing and Coding: MolDX: Blood Product Molecular Antigen Typing

This billing/coding guideline restricts Blood Product Molecular Antigen Typing panels 0001U and 0084U to a single lifetime claim per beneficiary and designates individual antigen codes (0180U–0201U, 0221U, 0222U, and CPT 81105–81112) as noncovered when billed separately; those individual codes are only considered when reported as part of an approved panel. Claims must include the appropriate CPT/PLA code, units of service, the DEX Z‑Code identifier placed in specified Part A/Part B fields, and an appropriate ICD‑10‑CM diagnosis code; clinical coverage is determined by the applicable MolDX LCD.

"Blood Product Molecular Antigen Typing is covered when ordered consistent with the applicable MolDX Local Coverage Determination (LCD) clinical indications."

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