Billing and Coding: MolDX: Testing of Multiple Genes

When two or more genes are assayed in parallel on the same date for the same indication, the tests constitute a single panel and must be billed as one HCPCS-coded procedural service; serial/reflex testing must be billed as individual gene services. All billed tests must be reasonable and necessary and documented in the medical record per CFR §410.32; labs must register tests in the Diagnostics Exchange and use modifier 59 to attest that additional same-date services are distinct when more than one procedural service is billed.

"When two or more genes are assayed in parallel on the same date of service (results of one do not affect whether others are performed) for the same clinical indication, the tests constitute a singl..."

Sign up to see full coverage criteria, indications, and limitations.