Billing and Coding: MolDX: Melanoma Risk Stratification Molecular Testing

DecisionDx‑Melanoma testing is covered under the MolDX policy for patients with cutaneous melanoma ≥0.3 mm without distant metastases when results will influence sentinel lymph node biopsy decisions (T1–T2), adjuvant therapy, or follow‑up/imaging/referrals, and for lesions <0.3 mm being considered for SLNB with uncertain microstaging or adverse features (e.g., mitotic index ≥2/mm2, lymphovascular invasion). Billing requires the appropriate CPT code with 1 unit of service, the DEX Z‑Code™ placed adjacent to the CPT in the specified Part A/Part B/paper claim fields, and an appropriate ICD‑10‑CM; tests not meeting these criteria per the MolDX LCD are not covered.