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 biomarker testing for risk stratification in MASLD and MASH and specifies claim submission requirements. Claims must report the appropriate CPT or PLA code, include the DEX Z-Code® adjacent to the procedure code (using specified electronic loops/fields or paper form boxes), include at least one ICD-10-CM code from Group 1 and one from Group 2, and may be billed no more than once per patient in a 12-month period with one unit of service per test.

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

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