Billing and Coding: MolDX: Minimal Residual Disease Testing for Hematologic Cancers (A58996) - R9 - Effective January 1, 2025

Date Posted: April 25, 2025

This Billing and Coding Article has been revised under contractor numbers: 01112 (NCA), 01182 (SCA), 01212 (AS, GU, HI, and NMI), and 01312 (NV).

Effective Date: January 1, 2025

Summary of Changes:

Under Article Text table 1 added "assays (a bundled service) in patients with cancer." to the Test box. Under Indicated Uses and Limitations deleted last sentence. Added new row for "ClonoSeq" to Test and Indicated Uses and Limitations boxes. Revised third paragraph to add "Testing schedules are set based on the validity established for the individual test comprising the service." Added new fourth paragraph. Under CPT/HCPCS Codes Group 2: Paragraph added "Use PLA 0364U to describe the service for patients with a personal history of cancer. This code has been approved for patients with a history of Mantle Cell Lymphoma." Under CPT/HCPCS Codes Group 2: Codes added 0364U. Under ICD-10 Codes that Support Medical Necessity Group 2: Codes added C83.1A and Z85.72. This revision is due to new covered test that has successfully completed a TA and is effective for 1/29/2025.

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