Billing and Coding: MolDX: Molecular Biomarkers for Risk Stratification of Indeterminate Pulmonary Nodules Following Bronchoscopy

This billing/coding guidance requires use of CPT 81479 (one unit) for MolDX molecular biomarker testing for risk stratification of indeterminate pulmonary nodules following bronchoscopy and limits billing to one test per patient. Claims must include the appropriate DEX Z-Code adjacent to the CPT code in the specified claim fields (Part B: Loop 2400 or SV101-7 for 837P, Item 19 for paper; Part A: SV202-7 for 837I, Block 80 for UB04) and report an appropriate ICD-10-CM diagnosis code; do not add extra characters on the SV101-7 line.

"Molecular biomarker testing for risk stratification of indeterminate pulmonary nodules performed following bronchoscopy (per MolDX program/LCD L39680)."

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