Billing and Coding: MolDX: Phenotypic Biomarker Detection from Circulating Tumor Cells

This billing and coding guideline complements MolDX LCD L38584 and identifies the Biocept Target Selector HER2 Assay and AR‑V7 protein test as reasonable and necessary when LCD clinical criteria are met. Claims must use CPT 81479 with 1 unit of service, include the appropriate DEX Z‑Code adjacent to the CPT code in specified Part A and Part B claim fields, and report an appropriate ICD‑10‑CM diagnosis code to support medical necessity.

"Biocept Target Selector HER2 Assay is considered reasonable and necessary when clinical criteria of MolDX LCD L38584 are met; report using CPT 81479 with the appropriate DEX Z-Code."

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