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

This billing and coding guideline requires that biomarker testing for MASLD/MASH follow the clinical coverage criteria of LCD DL40272 and be billed using the appropriate CPT or PLA code with the corresponding DEX Z-Code. Claims must include one unit of service, at least one ICD-10-CM code from Group 1 and one from Group 2, and only one test may be billed per patient per 12 months; specific Part A and Part B claim fields for entering the DEX Z-Code are prescribed.

"Biomarker testing for risk stratification in metabolic dysfunction-associated steatotic liver disease (MASLD) or metabolic dysfunction-associated steatohepatitis (MASH) is covered when the clinical..."

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