Billing and Coding: MolDX: EndoPredict® Breast Cancer Gene Expression Test

This billing/coding guidance instructs providers to report the EndoPredict® Breast Cancer Gene Expression Test using CPT code 81522 with 1 unit of service and to include the appropriate DEX Z-Code adjacent to the CPT code in specified claim fields for Part A and Part B claims. Providers must also select an appropriate ICD-10-CM diagnosis code; clinical coverage and medical necessity criteria are not included here and must be confirmed in the MolDx LCD for EndoPredict.

"Billing guidance applies to the EndoPredict® Breast Cancer Gene Expression Test when reported using CPT code 81522."

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