Billing and Coding: MolDX: Molecular Biomarkers to Risk-Stratify Patients at Increased Risk for Prostate Cancer

MolDX molecular biomarker tests to risk-stratify patients at increased risk for prostate cancer are covered per LCD L39007 when billed with the appropriate CPT and ICD-10-CM codes and the DEX Z-Code identifier. Claims must include one unit of service, place the DEX Z-Code in the specified Part A/Part B fields without extra characters, and only one biomarker test may be performed per date of service or per clinical indication as allowed by the policy.

"Molecular biomarker testing is covered to risk-stratify patients at increased risk for prostate cancer per the MolDX LCD L39007."

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