Billing and Coding: MolDX: Biomarker Testing for Risk Stratification in Metabolic Dysfunction-Associated Steatotic Liver Disease and Metabolic Dysfunction-Associated Steatohepatitis

This billing/coding guideline covers MolDX biomarker testing for risk stratification in MASLD and MASH per LCD DL40187 and specifies administrative claim requirements. Claims must use the correct CPT/PLA code with the appropriate DEX Z-Code entered in the specified claim field, include at least one ICD-10-CM from Group 1 and one from Group 2, and be billed as 1 unit; only one test is payable per patient every 12 months.

"Biomarker testing for risk stratification in Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and Metabolic Dysfunction-Associated Steatohepatitis (MASH) in accordance with LCD DL40..."

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