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

Non-NGS testing for diagnosis of BCR-ABL–negative myeloproliferative neoplasms is covered when LCD DL40000 criteria are met; single-gene non-NGS sequential/reflex testing is permitted under the LCD. Multi-gene panels (NGS or other methods) must be billed as a single panel (not as separate gene tests), NGS tests must comply with L38070/A57873, and the unit of service for each CPT/PLA code is limited to once per lifetime per diagnosis. Claims must report the appropriate CPT/PLA code with 1 UOS, include the DEX Z-Code in the specified claim fields, and list the appropriate ICD-10-CM diagnosis code.

"Non-next-generation sequencing (non-NGS) tests for the diagnosis of BCR-ABL–negative myeloproliferative neoplasms are covered when they meet all applicable criteria in LCD DL40000."

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