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

This billing/coding guideline requires a single molecular biomarker test per patient (report as 1 UOS) and mandates reporting the appropriate CPT and ICD-10-CM codes. The DEX Z-Code identifier must be entered adjacent to the CPT code in specified Part A and Part B claim fields (Loop 2400/SV101-7 or Box 19 for Part B; SV202-7 or Block 80 for Part A) and must not include additional characters on SV101-7.

"Do not add additional characters or information when entering the DEX Z-Code on the SV101-7 documentation field for Part B claims."

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