Billing and Coding: MolDX: Prometheus® IBD sgi Diagnostic® Policy

This billing and coding guideline requires submitting the applicable CPT code with one unit of service for the Prometheus IBD sgi Diagnostic test and provides instructions for DEX Z‑Code placement on Part A and Part B claim forms. It clarifies that ABNs are not required for statutorily excluded services (use modifier GY to indicate), while a voluntary ABN must be appended with modifier GX.

"An Advance Beneficiary Notice (ABN) is not required for statutorily excluded services."

Sign up to see full coverage criteria, indications, and limitations.