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

Coverage is allowed for specified MolDX-assessed molecular tests for solid organ allograft rejection when used for the listed organ-specific indications (for-cause or surveillance) and when billed in compliance with LCD DL40058 and this billing policy. Claims must report the correct CPT, UOS=1, appropriate DEX Z-Code (using distinct Z-Codes for for-cause vs surveillance year 1 vs subsequent surveillance), and an ICD-10-CM code; only one molecular test bundle may be billed per patient encounter and dd-cfDNA-only tests have minimum post-transplant timing requirements.

"AlloMap (CareDx) is covered for heart surveillance testing when performed at least 55 days (≥55 days) post-transplantation."

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