Billing and Coding: MolDX: Non-Next Generation Sequencing Tests for the Diagnosis of BCR-ABL Negative Myeloproliferative Neoplasms
A59835
This billing/coding article covers non-next-generation sequencing (non-NGS) tests used to diagnose BCR-ABL negative myeloproliferative neoplasms when they meet the clinical criteria in MolDX LCD L39923; single-gene non-NGS testing performed sequentially/reflexively is permitted under the same LCD criteria. Multi-gene panels (NGS or other) must be billed as a single panel unit and cannot be unbundled, with each CPT/PLA code limited to one unit once per lifetime per diagnosis; NGS testing must comply with MolDX L38123 and related billing articles. Claims must include the appropriate CPT and ICD-10-CM codes, report 1 unit of service, and include the correct DEX Z-Code identifier in the specified Part A/Part B claim fields without additional characters.
"Non-next-generation sequencing (non-NGS) tests for the diagnosis of BCR-ABL negative myeloproliferative neoplasms are covered when they meet the clinical criteria specified in MolDX LCD L39923."