Billing and Coding: MolDX: Molecular Biomarker Testing for Risk Stratification of Cutaneous Squamous Cell Carcinoma

This billing and coding guidance requires that molecular biomarker testing for risk stratification of cutaneous squamous cell carcinoma be billed in accordance with MolDX LCD L39594 and that specific claim fields be populated correctly. Required claim elements include the appropriate CPT and ICD-10-CM codes, exactly 1 unit of service, and the DEX Z‑Code entered adjacent to the CPT code in the specified Part A and Part B claim fields (with no extra characters on SV101-7); omissions may result in claim denial.

"Molecular biomarker testing for risk stratification of cutaneous squamous cell carcinoma is covered when performed consistent with the MolDX Local Coverage Determination L39594."

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