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

This billing/coding guidance complements LCD L39481 and requires that only one MolDX molecular biomarker test be performed per patient. Claims must report the appropriate CPT and ICD-10-CM codes, enter 1 unit of service, and include the DEX Z-Code adjacent to the CPT in the specified claim fields (Part B: Loop 2400/SV101-7 or Box 19; Part A: SV202-7 or Block 80), without adding extra characters on SV101-7.

"Only one molecular biomarker test (MolDX) may be performed for a given patient; repeat testing is not permitted."

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