Billing and Coding: MolDX: Proteomics Testing

MolDX defines proteomics tests as multianalyte assays in which proteins are major analytes and the clinical validity depends on measured interactions, requiring informatics (algorithms/nomograms) to produce results. All proteomics tests in MolDX jurisdictions must register with the DEX Registry and obtain a Z-Code, be billed with an appropriate CPT/PLA or 81599 code, include 1 unit of service, and submit the Z-Code in specified claim fields; tests will undergo Technical Assessment by Palmetto GBA (effective 2024-01-31) with reimbursement changes enforcement delayed until 2025-01-31.

"A test is considered a proteomics test if it is a multianalyte assay in which proteins are the major or essential analytes measured."

Sign up to see full coverage criteria, indications, and limitations.