Billing and Coding: MolDX: Predictive Classifiers for Early Stage Non-Small Cell Lung Cancer

This billing/coding guidance states that predictive classifier tests for early-stage non-small cell lung cancer are covered when billed in accordance with LCD L38238. Claims must report the appropriate CPT code with 1 unit of service, include the corresponding DEX Z‑Code in the specified Part A/Part B claim fields, and list an appropriate ICD-10-CM diagnosis code. Detailed clinical coverage criteria and exclusions are contained in LCD L38238 and should be consulted for medical necessity determinations.

"Tests described in LCD L38238 (MolDX: Predictive Classifiers for Early Stage Non-Small Cell Lung Cancer) are covered in accordance with that LCD."

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