Billing and Coding: MolDX: Next-Generation Sequencing for Solid Tumors

Claims for MolDX Next-Generation Sequencing (NGS) for solid tumors must include the appropriate CPT code and a supporting ICD-10-CM diagnosis code, and must report one unit of service. The DEX Z-Code identifier must be entered adjacent to the CPT code in the specified claim field depending on Part A or Part B (Loop 2400/SV101-7 or Box 19 for Part B; Line SV202-7 or Block 80 for Part A), and no extra characters should be added when using SV101-7 for Part B.

"For Next-Generation Sequencing (NGS) services for solid tumors covered under MolDX LCD L38045, submit the claim using the appropriate CPT code for the NGS service."

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