Billing and Coding: MolDX: Non-Next Generation Sequencing Targeted Molecular Panel Tests for Predictive Testing in Cancer

This article provides billing instructions for Non-Next Generation Sequencing targeted molecular panel tests for predictive cancer testing: claims must include the appropriate CPT code, one unit of service (1 UOS), the appropriate DEX Z-Code adjacent to the CPT in the specified electronic/paper claim fields (Part B: Loop 2400/SV101-7 or Item 19; Part A: SV202-7 or UB-04 Block 80), and an appropriate ICD-10-CM diagnosis code. Claims must follow LCD DL40222 and related MolDX billing/coding articles, and do not include extra characters on the SV101-7 line when entering the DEX Z-Code.

"When entering the DEX Z-Code on the SV101-7 documentation field for Part B claims, do not add additional characters or other information on that line."

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