Billing and Coding: MolDX: Non-Next Generation Sequencing Tests for the Diagnosis of BCR-ABL Negative Myeloproliferative Neoplasms

Non‑NGS molecular testing for the diagnosis of BCR‑ABL negative myeloproliferative neoplasms is covered when LCD DL39927 criteria are met; single‑gene sequential/reflexive non‑NGS testing is allowed if LCD criteria are satisfied. Multi‑gene panels (NGS or other methods) must be billed as panels (not as separate individual gene tests), the listed CPT/PLA codes are limited to one lifetime use per diagnosis, and claims must include the correct CPT, 1 unit of service, the appropriate DEX Z‑Code in the specified claim fields, and the relevant ICD‑10‑CM code; NGS tests must comply with L38125 and A57892.

"Non‑NGS molecular testing is covered for the diagnosis of BCR‑ABL negative myeloproliferative neoplasms when the criteria of LCD DL39927 are met."

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