Billing and Coding: MolDX: Plasma-Based Genomic Profiling in Solid Tumors

This policy provides billing and coding instructions for plasma-based genomic profiling in solid tumors, requiring submission of the appropriate CPT code, one unit of service (UOS=1), the DEX Z-Code identifier adjacent to the CPT code, and an applicable ICD-10-CM diagnosis code. The DEX Z-Code must be entered in specified claim fields (Loop 2400 or SV101-7/Item 19 for Part B; SV202-7/Block 80 for Part A) and must not include additional characters when placed on SV101-7.

"When entering the DEX Z-Code on the SV101-7 field for Part B claims, do not add any additional characters or information on the line."

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