Billing and Coding: MolDX: Genetic Testing for Hypercoagulability / Thrombophilia (Factor V Leiden, Factor II Prothrombin, and MTHFR)

This policy provides billing and coding instructions for genetic testing for hypercoagulability/thrombophilia (Factor V Leiden/F5, Factor II/Prothrombin/F2, and MTHFR). Claims must report the appropriate CPT code with 1 unit of service and include the DEX Z-Code adjacent to the CPT in the specified comment/narrative fields for Part A and Part B claims. When placing the DEX Z-Code on the SV101-7 field (Part B 5010A1 837P), no additional characters or information may be added.

"Do not add any additional characters or information on the SV101-7 documentation field when entering the DEX Z-Code for Part B claims."

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