Billing and Coding: MolDX: Molecular Testing for Detection of Upper Gastrointestinal Metaplasia, Dysplasia, and Neoplasia

This billing and coding guideline specifies required claim elements for MolDX molecular testing for detection of upper gastrointestinal metaplasia, dysplasia, and neoplasia. Claims must report the appropriate CPT and ICD-10-CM codes, include exactly 1 unit of service, and include the DEX Z-Code adjacent to the CPT code in the designated electronic or paper claim fields (Part A and Part B) to avoid denial.

"Claims that do not include the required DEX Z-Code identifier adjacent to the CPT code, the appropriate CPT code, and the appropriate ICD-10-CM code may be denied."

Sign up to see full coverage criteria, indications, and limitations.