Article Detail - JE Part A
Billing and Coding: MolDX: FDA-Approved BRAF Tests (A54418) - R7 - Effective July 27, 2023
This coverage article has been revised and published for notice under contract numbers: 01111 (CA), 01211 (AS, GU, HI, NMI), 01311 (NV), and 01911 (CA, HI & Territories).
Effective Date: July 27, 2023
Summary of Article Changes: Under ICD-10 Codes that Support Medical Necessity Group 1: Codes added C91.40 and C91.42.
Under CMS National Coverage Policy re-added Title XVIII of the Social Security Act, §1833(e) prohibits Medicare payment for any claim which lacks the necessary information to process the claim effective on 03/03/2022.
Visit the Molecular Diagnostic Services (MolDX) webpage to access the MolDX Medicare Coverage Article from the "Covered Tests" or the "Excluded Tests" webpage.
To view the complete listing of coverage articles and/or access the Active, Future, or Retired articles available in the CMS MCD, visit the Medicare Coverage Articles webpage.
