Billing and Coding: MolDX: Molecular Assays for the Diagnosis of Cutaneous Melanoma

This billing/coding guideline specifies CPT/PLA coding for molecular assays for cutaneous melanoma: use CPT 81479 for myPath® Melanoma prior to 2019-07-01 and PLA/CPT 0090U on or after 2019-07-01; use CPT 81479 for other assays when no specific code exists. Only one molecular test (report 1 UOS) may be billed per patient per melanocytic lesion, and claims must include the appropriate DEX Z-Code® adjacent to the CPT/PLA code and the appropriate ICD-10-CM diagnosis code using the specified electronic or paper claim fields.

"For the myPath® Melanoma assay, bill CPT code 81479 for dates of service prior to 2019-07-01 and PLA/CPT code 0090U for dates of service on or after 2019-07-01."

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