Billing and Coding: ProMark® Risk Score

Covered: The ProMark® assay must be billed using CPT® code 81479 with one unit of service. Key requirements: include the appropriate DEX Z‑Code adjacent to the CPT code in the claim narrative (Part B: Loop 2400/SV101‑7 for 837P or Box 19 for paper; Part A: Line SV202‑7 for 837I or Block 80 on UB‑04) and report ICD‑10‑CM code C61.

"ICD-10-CM C61 Malignant neoplasm of prostate (listed under 'ICD-10-CM Codes that Support Medical Necessity')."

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