Billing and Coding: MolDX: Non-Next Generation Sequencing Tests for the Diagnosis of BCR-ABL Negative Myeloproliferative Neoplasms
A59827
This billing and coding article covers non-NGS testing for the diagnosis of BCR-ABL negative myeloproliferative neoplasms when performed in accordance with LCD L39919; sequential single-gene non-NGS testing is allowed if LCD criteria are met and NGS panels may be used in select circumstances per the LCD. Multi-gene panels must be billed as a single panel unit and the CPT/PLA codes listed are limited to one unit once per lifetime per diagnosis; NGS tests must comply with MolDX L38047/A57837 and BCR-ABL testing must follow A53531. Specific claim submission requirements include entering 1 UOS, selecting the appropriate CPT and ICD-10-CM codes, and placing the DEX Z-Code identifier in the designated claim fields (SV101-7/Loop 2400/Box 19 for Part B and SV202-7/Block 80 for Part A).
"Non-next-generation sequencing (non-NGS) tests are covered when performed for the diagnosis of BCR-ABL negative myeloproliferative neoplasms (MPNs) in accordance with the LCD L39919 criteria."