Billing and Coding: MolDX: Breast Cancer Assay: Prosigna®

Billing for the Prosigna® breast cancer assay requires use of CPT code 81520 with 1 unit of service and an appropriate ICD-10-CM diagnosis code. The claim must include the appropriate DEX Z-Code identifier entered adjacent to the CPT code in the specified comment/narrative fields for Part B (Loop 2400 or SV101-7 for 837P, Box 19 for paper) or Part A (Line SV202-7 for 837I, Block 80 for UB04).

"Report the Prosigna® assay using CPT code 81520."

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