Billing and Coding: MolDX: Molecular Biomarkers to Risk-Stratify Patients at Increased Risk for Prostate Cancer (A58724) - R4 - Effective November 28, 2024

Date Posted: December 2, 2024

This Billing and Coding article has been revised under contractor numbers: 02101 (AK), 02201 (ID), 02301 (OR), 02401 (WA), 03101 (AZ), 03201 (MT), 03301 (ND), 03401 (SD), 03501 (UT), and 03601 (WY).

Effective Date: November 28, 2024

Summary of Changes:

Under CPT/HPCS Codes Group 1: Paragraph added "MyProstate Score 2.0 (MPS 2.0) (PLA 0403U), performed on non-DRE urine specimens". Under CPT/HCPCS Codes Group 1: Codes added 0403U. Under CPT/HPCS Codes Group 2: Paragraph added "MyProstate Score 2.0 (MPS 2.0) (PLA 0403U), performed on non-DRE urine specimens". Under CPT/HCPCS Codes Group 2: Codes added 0403U. Formatting was corrected throughout the article. This revision is due to new covered assay that has successfully completed a TA and is effective 9/11/2024.

Under CPT/HPCS Codes Group 1: Paragraph added "ExoDX Prostate assay (PLA 0005U), performed on non-DRE urine specimens". Under CPT/HPCS Codes Group 2: Paragraph added "ExoDX Prostate assay (PLA 0005U), performed on non-DRE urine specimens". This revision is due to covered assay that has successfully completed a TA and is effective 12/27/2023.

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