Billing and Coding: MolDX: Genetic Testing for Hereditary Thrombophilia

This billing and coding guidance requires use of CPT codes 81240, 81241, or 81479 with 1 unit of service per CPT line for genetic testing related to hereditary thrombophilia. Claims must include the appropriate DEX Z-Code adjacent to the CPT code (specific SV/loop/box fields differ for Part A vs Part B and electronic vs paper claims) and list the appropriate ICD-10-CM diagnosis code(s); do not add extra characters when entering the DEX Z-Code on SV101-7.

"Submit only CPT codes 81240, 81241, or 81479 for genetic testing related to this billing guideline."

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