Billing and Coding: MolDX: Short Tandem Repeat (STR) Markers and Chimerism (CPT® codes 81265-81268)
A57843
MolDX covers STR/chimerism testing for transplant recipient/donor identification and for monitoring engraftment or disease recurrence (CPT 81265–81268). CPT 81265 is for pre-transplant recipient/donor testing and should be billed as 1 unit and is generally limited to once per lifetime (exceptions by appeal); CPT 81266 covers additional double-cord blood samples in bone marrow transplants, CPT 81267 is for post-transplant confirmation/comparison, and CPT 81268 is for post-transplant germline (e.g., buccal) recipient specimens. Twin zygosity testing is statutorily excluded, duplicate submissions of 81265 with 81267 are generally not expected (with limited exceptions when pre-transplant specimens are held), and DEX Z-Code identifiers must be reported adjacent to CPT codes on specified claim fields.
"Chimerism analysis to identify appropriate donors and to monitor engraftment success or disease recurrence is a covered Medicare service."