Billing and Coding: MolDX: Oncotype DX® Breast Cancer for DCIS (Genomic Health™)

This policy provides billing and coding instructions for reporting the Oncotype DX Breast Cancer for DCIS assay: use PLA code 0045U, report one unit of service, and include the appropriate ICD-10-CM diagnosis. The DEX Z-Code identifier must be entered adjacent to the CPT code in the specified electronic or paper claim fields (Part B: Loop 2400/SV101-7 or Item 19; Part A: SV202-7 or UB04 Block 80).

"Claims for the Oncotype DX Breast Cancer for DCIS test (Genomic Health) should be reported using the specified billing/coding instructions in this policy."

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