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Billing and Coding: MolDX: Proteomics Testing
A59646
Effective: October 1, 2025
Updated: December 31, 2025
Policy Summary
MolDX defines proteomics tests as multianalyte assays where proteins are essential analytes, the clinical result depends on analyte interactions, informatics are required, and clinical validity is demonstrated based on those interactions. All such tests in MolDX jurisdictions must register with the DEX registry and obtain a Z-Code, be submitted with an appropriate CPT/PLA/NOC code and one unit of service, and will undergo Technical Assessment by Palmetto GBA (requirement effective 2024-01-31; reimbursement enforcement delayed until 2025-01-31).
Coverage Criteria Preview
Key requirements from the full policy
"A test is considered a proteomics test if it is a multianalyte test that includes proteins as the major or essential analytes."
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