Billing and Coding: MolDX: Next-Generation Sequencing Lab-Developed Tests for Myeloid Malignancies and Suspected Myeloid Malignancies

This article provides billing and claim-submission instructions for Next-Generation Sequencing lab-developed tests (LDTs) for myeloid malignancies and suspected myeloid malignancies. Claims must include the appropriate CPT code (reported as 1 UOS), the appropriate DEX Z-Code adjacent to the CPT code in the specified comment/narrative claim fields for Part A and B (with no extra characters on SV101-7), and the appropriate ICD-10-CM diagnosis code; clinical coverage criteria are governed by the referenced LCD L38123.

"Claims for Next-Generation Sequencing (NGS) lab-developed tests (LDTs) for myeloid malignancies and suspected myeloid malignancies should be billed using the instructions below."

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