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

This billing/coding guidance complements LCD L39614 for molecular biomarker testing to risk-stratify cutaneous squamous cell carcinoma. Claims must include the appropriate CPT code, 1 unit of service, the DEX Z-Code entered adjacent to the CPT in the specified Part A/Part B claim fields (Loop 2400 or SV101-7 or Box 19 for Part B; SV202-7 or Block 80 for Part A), and an appropriate ICD-10-CM diagnosis code; do not add extra characters when entering the DEX Z-Code on SV101-7.

"Molecular biomarker testing for risk stratification of cutaneous squamous cell carcinoma when the Local Coverage Determination L39614 clinical coverage criteria are met."

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