Date Posted: August 6, 2026

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

Effective Date: August 30, 2026

Summary of Changes:

Updated Article Text: Billing information: Second paragraph; replaced word "cannot" with "should not". Added bullets to include sentences "Frequency limits for surveillance testing apply as outlined in the LCD." and "As stated in the LCD, surveillance testing will not be reimbursed if for-cause testing has been performed within the prior month." Removed sentences: "If the service billed is series of assays, use CPT code 81479 and the assigned Z-Code. If the service is billed as a single assay/timepoint, use 81479 or the appropriate CPT/PLA code and the assigned Z-Code." and "If the service billed is a single assay/timepoint, frequency limits for surveillance testing outlined in the LCD apply. Any tests billed above those frequency limits must be billed with modifier KX and may be subject to medical review and denial." Under subheading: Solid Organ Allograft Rejection Tests that meet coverage criteria of Policy L40060; corrected first bullet to read "The tests below have completed a MolDX technical assessment and are deemed compliant with policy only for the specific indications listed; they must be billed in compliance with the policy requirements." Under subheading: Additional Notes: Corrected first bullet to read " To-date, NO test has met policy criteria for surveillance testing past 5 years post-transplantation. Such claims will be denied but may be appealed to allow for manual review.

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