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Billing and Coding: MolDX: Pigmented Lesion Assay
A57983
Wisconsin Physicians Service Insurance Corporation (J05)
Effective: December 28, 2023
Updated: December 31, 2025
Policy Summary
This billing/coding guideline requires reporting the appropriate CPT code and selecting the appropriate ICD-10-CM diagnosis code(s) for the MolDX Pigmented Lesion Assay. Claims must report 1 unit of service and include the DEX Z-Code identifier adjacent to the CPT code in the specified comment/narrative fields for Part A (Line SV202-7 or Block 80) and Part B (Loop 2400/SV101-7 or Box 19) claim types.
Coverage Criteria Preview
Key requirements from the full policy
"Report the appropriate CPT code for the MolDX Pigmented Lesion Assay on the claim."
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