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

Biomarker testing for risk stratification is covered when ordered for patients with MASLD or MASH and must be billed using the appropriate CPT or PLA code with one unit of service. Claims must include the DEX Z-Code adjacent to the CPT code in the specified Part A or Part B comment/narrative fields and appropriate ICD-10-CM codes (at least one from Group 1 and one from Group 2). Only one test may be billed per patient every 12 months.

"Biomarker testing for risk stratification is covered when ordered for patients with Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) or Metabolic Dysfunction-Associated Steatohepati..."

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