Billing and Coding: MolDX: Molecular Testing for Solid Organ Allograft Rejection

This policy lists MolDx‑assessed molecular tests for solid organ allograft rejection (e.g., AlloMap, AlloSure, Prospera, QSant, Tutivia, TruGraf, Viracor TRAC, VitaGraft) that are considered compliant when used per the coverage criteria in LCD L38629. Claims must include the CPT code (1 unit), the appropriate DEX Z‑Code adjacent to the CPT in the specified Part A/B claim fields, and an appropriate ICD‑10‑CM diagnosis code; consult the DEX registry to confirm covered tests. Clinical indications, exclusions, and frequency limits are determined by LCD L38629 and tests not meeting those criteria or not listed on the DEX registry are not covered.

"AlloMap (CareDx) is covered for heart transplant recipients when billed in accordance with the coverage criteria of LCD L38629."

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