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

This billing and coding guidance supplements LCD L38647 for MolDX prognostic and predictive molecular classifiers for bladder cancer and specifies how to report claims. Providers must report the appropriate CPT code with 1 unit of service, include the DEX Z-Code identifier adjacent to the CPT code in the specified electronic or paper claim fields (Loop 2400/SV101-7, Item 19, SV202-7, Block 80), and report an appropriate ICD-10-CM diagnosis code. Do not add extra characters to the SV101-7 line when entering the DEX Z-Code.

"Billing and coding guidance applies to MolDX prognostic and predictive molecular classifier tests for bladder cancer as described in LCD L38647."

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