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

Non-NGS single-gene testing (e.g., sequential/reflexive single-gene PCR) is covered for diagnosing BCR-ABL-negative myeloproliferative neoplasms when LCD criteria are met, while NGS testing must follow separate NGS policies (L38070/A57873). Multi-gene tests performed by NGS or other methods must be billed as panels (not as separate genes), each CPT/PLA code is limited to one unit of service once per lifetime per diagnosis, and claims must include the specified CPT/PLA code, 1 UOS, the appropriate DEX Z-Code in the designated claim field, and an ICD-10-CM code.

"Single-gene, non-NGS tests (e."

Sign up to see full coverage criteria, indications, and limitations.