Billing and Coding: MolDX: Minimal Residual Disease Testing for Hematologic Cancers

ClonoSeq® (NGS‑based MRD) is covered for MRD testing in ALL, MM, CLL, DLBCL, and mantle cell lymphoma, with billing as one unit of service (UOS) at the start of an episode of testing; single timepoint testing is permitted for patients with a personal history of cancer. Standard single‑gene PCR MRD tests (e.g., BCR‑ABL1) are covered per national/society guidelines and billed 1 UOS per date of service. All tests must be registered with the DEX Diagnostic Exchange, include the DEX Z‑Code on claims, be supported by medical‑necessity documentation (and MolDX TA forms when available), and testing frequency is limited (generally no more than once per month and typically once per diagnosis for NGS MRD unless genetic change is documented).

"ClonoSeq® is covered for MRD testing in patients with acute lymphoblastic leukemia (ALL), multiple myeloma (MM), chronic lymphocytic leukemia (CLL), diffuse large B‑cell lymphoma (DLBCL), and mantl..."