Billing and Coding: MolDX: Melanoma Risk Stratification Molecular Testing

This billing and coding guidance complements MolDX LCD D_L38016 and requires that molecular melanoma risk stratification tests be reported only when LCD clinical criteria are met. Claims must include the appropriate CPT and ICD-10-CM codes, report exactly 1 unit of service, and include the correct DEX Z-Code adjacent to the CPT in the specified Part A/Part B claim fields (with no additional characters on SV101-7).

"Coverage and medical necessity determinations for melanoma risk stratification molecular testing are governed by the MolDX LCD D_L38016 and tests should be reported only when LCD clinical criteria ..."

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