Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing: (A58720) - R22 - Effective September 13, 2024

Date Posted: December 5, 2024

This Billing and Coding Article has been revised under contractor numbers: 01111 (CA), 01211 (AS, GU, HI, NMI), 01311 (NV), and 01911 (CA, HI & Territories).

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.

Visit the Noridian Molecular Diagnostic Services webpage to view the Active MolDX LCDs or access it via the CMS MCD.

Last Updated Dec 05 , 2024