Billing and Coding: MolDX: Testing of Multiple Genes

A multi-gene panel (genes assayed in parallel for the same indication) is a single procedural service and must be billed with the appropriate single panel HCPCS/CPT code and documented as reasonable and necessary. Serial or reflex testing requires billing each gene individually with documentation that each individual gene test is reasonable and necessary; billing multiple distinct services on the same date requires use of modifier 59 on each additional service and may trigger review if used frequently.

"When two or more genes are assayed in parallel for the same clinical indication (result of one assay does not affect performing another), those genes constitute a single gene panel and may be bille..."

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