Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing: (A58726) - R22 - Effective September 13, 2024

Date Posted: December 5, 2024

This Billing and Coding Article has been revised under contractor numbers: 02102 (AK), 02202 (ID), 02302 (OR), 02402 (WA), 03102 (AZ), 03202 (MT), 03302 (ND), 03402 (SD), 03502 (UT), and 03602 (WY).

Effective Date: September 13, 2024

Summary of Changes:

Under CPT/HCPCS Codes Group 12: Paragraph added "Onychomycosis Panels: This code is only reimbursed for patients with a confirmed histopathologic diagnosis of an infiltrative/invasive fungal onychomycosis and whose culture (and antifungal susceptibility) of the nail is negative or cannot be performed." Under CPT/HCPCS Codes Group 12: Codes added 87999. Under CPT/HCPCS Modifiers Group 12: Codes added 59. Under ICD-10 Codes that Support Medical Necessity Group 12: Paragraph added "These are the diagnosis codes corresponding to coverage of CPT/ HCPCS Codes Group 12: Codes-Onychomycosis Panels." Under ICD-10 Codes that Support Medical Necessity Group 12: Codes added B35.1. This revision is effective 9/13/2024.

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