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Billing and Coding: MolDX: Molecular Biomarker Testing for Risk Stratification of Cutaneous Squamous Cell Carcinoma
A59380
Effective: August 18, 2024
Updated: December 31, 2025
Policy Summary
This billing/coding guidance applies to MolDX molecular biomarker testing for risk stratification of cutaneous squamous cell carcinoma and specifies required claim elements. Claims must include the appropriate CPT and ICD-10-CM codes, exactly 1 unit of service, and the DEX Z-Code placed adjacent to the CPT code in the specified Part A/Part B claim fields (with no extra characters on SV101-7 for Part B).
Coverage Criteria Preview
Key requirements from the full policy
"Use this billing/coding guidance when submitting claims for MolDX molecular biomarker testing for risk stratification of cutaneous squamous cell carcinoma (cSCC)."
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