Billing and Coding: MolDX: Molecular Biomarker Testing to Guide Targeted Therapy Selection in Rheumatoid Arthritis

This billing/coding guideline requires that only one molecular biomarker test for targeted therapy selection in rheumatoid arthritis be performed per patient. Claims must report the appropriate CPT and ICD-10-CM codes, include 1 unit of service, and include the DEX Z-Code adjacent to the CPT in the specified Part A and Part B claim fields (with no extra characters on SV101-7).

"Only one molecular biomarker test for targeted therapy selection may be performed for a given patient."

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