Article Detail - JE Part A
Billing and Coding: MolDX: MammaPrint (A54445) - R7 - Effective January 01, 2022
This Billing and Coding 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: January 01, 2022
Summary of Article Changes:
Under Article Text deleted the first paragraph. The second paragraph was revised to read, “MammaPrint® is a diagnostic test that analyzes the gene expression profile of FFPE breast cancer tissue samples to assess a patient’s risk for distant metastasis” and a new third paragraph was added. The second bullet point was revised to add the verbiage, “For dates of service on or after 01/01/2022, use CPT code 81523 for the test if performed by NGS”. A new paragraph was added after verbiage regarding instructions on how to submit claims information. This revision is effective for dates of service on or after 1/1/2022.
Under CPT/HCPCS Codes Group 1: Codes added 81523. This revision is due to the 2022 Annual CPT/HCPCS Code Update and is effective on 1/1/2022.
Visit the Molecular Diagnostic Services (MolDX) webpage to access the locally hosted MolDX Medicare Coverage Article from the “Covered Tests” or the “Excluded Tests” webpage.
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Last Updated Fri, 28 Jan 2022 16:02:11 +0000