Billing and Coding: MolDX: Minimal Residual Disease Testing for Solid Tumor Cancers

This policy covers specified MRD plasma and NGS-based assays for defined indications in patients with and without active cancer when clinical validity is met and when tumor profiling is used (or explicitly allowed as tumor‑naïve for certain assays). Coverage requires documentation of medical necessity per the related LCD, registration with DEX and submission of the assigned DEX Z‑Code with appropriate CPT and ICD‑10 codes; for patients with cancer the test is generally limited to one UOS per cancer diagnosis unless there is documented genetic change, and testing in patients without active cancer is limited to one test per 30 days.

"Initial MRD testing is covered for patients with cancer when tumor profiling (prior tumor analysis) is utilized, using the listed covered assays (e."

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