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

This billing/coding guideline requires that molecular biomarker testing to guide targeted therapy selection in rheumatoid arthritis be ordered per MolDX LCD L39469 and that only one such test may be performed and billed per patient. Claims must include the appropriate CPT and ICD-10-CM codes, be billed as 1 unit of service, and include the correct DEX Z‑Code adjacent to the CPT in the specified claim fields (with no additional characters on SV101-7).

"Molecular biomarker testing to guide targeted therapy selection in patients with rheumatoid arthritis when ordered and justified per MolDX LCD L39469."

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