Billing and Coding: MolDX: Molecular Testing for Solid Organ Allograft Rejection

MolDX-covered molecular tests for solid organ allograft rejection are payable only when they meet LCD DL40060 coverage criteria and the specific assay has completed MolDX technical assessment and is listed in the DEX registry. Only one molecular service (UOS=1) may be billed per patient encounter, correct CPT/ICD-10 and the appropriate DEX Z-code (indicating organ and intended use: For‑Cause, Surveillance Year 1, Subsequent Surveillance) must be submitted in the specified claim fields; molecular testing and biopsy generally cannot be billed on the same date of service. Specific covered assays and organ‑level indications are listed (e.g., AlloMap for heart surveillance >=55 days post-transplant; multiple dd‑cfDNA assays for kidney, heart, and certain lung indications) and certain assays have minimum post‑transplant timing requirements (dd‑cfDNA >=14 days unless otherwise noted).

"Molecular testing for assessment of solid organ allograft rejection is covered when the test meets the coverage criteria of LCD DL40060 and the specific assay has completed the MolDX technical asse..."