Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing

Molecular syndromic infectious disease panels are covered when billed with the correct CPT/PLA (or CPT 87999 with a DEX Z-Code and MolDX Technical Assessment) and accompanied by ICD-10-CM diagnosis codes and supporting medical record documentation. Expanded (>5 pathogen) RP/PNP/GI panels have additional place-of-service or ordering-specialist requirements based on beneficiary immune status, panels are reported as a single unit of service (UOS=1), cannot be unbundled, and repeat testing is generally limited except for one conditional repeat within 1–14 days.

"Molecular syndromic infectious disease panels are covered when billed with the appropriate proprietary CPT®/PLA code (or CPT® 87999 if no specific code exists) and accompanied by ICD-10-CM diagnosi..."

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