Billing and Coding: MolDX: Breast Cancer Index® (BCI) Gene Expression Test

MolDX provides limited coverage for the Breast Cancer Index (BCI) gene expression test for postmenopausal women with invasive ER+ and/or PR+, HER2- early-stage breast cancer (T1-T3, pN0-pN1, M0) who have no distant metastasis and whose test results will be used to guide chemotherapy and/or endocrine therapy. Testing is expected once per patient lifetime using FFPE primary tumor tissue obtained prior to adjuvant treatment; claims must report CPT 81518, unit of service, the appropriate DEX Z-Code identifier in the specified claim fields, and an appropriate ICD-10-CM diagnosis code.

"Patient is a postmenopausal woman."

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