Billing and Coding: MolDX: Prognostic and Predictive Molecular Classifiers for Bladder Cancer

This billing/coding guideline specifies claim submission requirements for MolDX prognostic and predictive molecular classifiers for bladder cancer: report the appropriate CPT and ICD-10-CM codes, enter 1 unit of service, and include the DEX Z-Code adjacent to the CPT code in the specified comment/narrative fields. DEX Z-Code placement differs by claim type (Part B: Loop 2400/SV101-7 for 837P or Box 19 for paper; Part A: Line SV202-7 for 837I or Block 80 for UB04), and no additional characters may be added when entering the DEX Z-Code 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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