Billing and Coding: MolDX: Plasma-Based Genomic Profiling in Solid Tumors

This billing and coding guidance specifies required claim data to report MolDX plasma-based genomic profiling in solid tumors: select the appropriate CPT and ICD-10-CM codes, report one unit of service, and include the DEX Z-Code identifier adjacent to the CPT code. DEX Z-Codes must be placed in specified fields depending on claim type (Part B: Loop 2400 or SV101-7 for 837P, Box 19 for paper; Part A: SV202-7 for 837I, Block 80 for UB04) and must not include additional characters on SV101-7.

"When entering the DEX Z-Code on the SV101-7 documentation field for Part B claims, do not add additional characters or other information on that line."

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