Billing and Coding: MolDX: Genetic Testing for Hereditary Thrombophilia

This billing and coding guidance requires genetic testing for hereditary thrombophilia to be billed using CPT codes 81240, 81241, or 81479 with one unit of service per line and appropriate ICD-10-CM diagnosis codes. For claims, include the correct DEX Z-Code identifier adjacent to the CPT code in the specified electronic or paper fields (Loop 2400/SV101-7 or Item 19 for Part B; SV202-7 or Block 80 for Part A) and do not add extra characters when entering the DEX Z-Code on SV101-7.

"Genetic testing for hereditary thrombophilia should be billed using CPT codes 81240, 81241, or 81479 in accordance with LCD DL40242."

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