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

MolDX covers the Breast Cancer Index (BCI) test for postmenopausal women with invasive, ER+ and/or PR+, HER2- early-stage breast cancer (T1-T3, pN0-pN1, M0) when results will inform chemotherapy and/or endocrine therapy decisions. The test should be performed once per patient lifetime on FFPE primary tumor tissue obtained prior to adjuvant treatment; claims must use CPT 81518 with the appropriate DEX Z-Code™ and appropriate ICD-10-CM diagnosis coding.

"Covered for postmenopausal women with invasive breast carcinoma."

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