Billing and Coding: MolDX: Multiplex Nucleic Acid Amplified Tests for Respiratory Viral Panels (A57338) - R15 - Effective February 03, 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: February 03, 2022

Summary of Article Changes:
Under CPT/HCPCS Codes Group 1: Paragraph deleted the sentence, "May only be billed in places of service 20, 21, 23, or 81 (Urgent care, Inpatient hospital, Emergency room, or Independent Laboratory respectively)" and added new paragraph that reads, "During the Federally designated public health emergency (PHE), the following place of service (POS) codes may be billed: 05, 06, 07, 08, 11, 17, 19, 20, 21, 22, 23, 24, 26, 49, 50, 71, 72, 81." The sentence, "The following paragraph does not apply during the PHE:" was added before the last paragraph. Under Group 1 ICD-10 Codes: Added J09.X1, J09.X2, J09.X3, J09.X9, J12.0, J12.1, J12.3

This revision is retroactive effective for dates of service on or after 02/03/2021.

04.01.2021: Typographical Error: Under ICD-10 Codes that Support Medical Necessity Group 1: Code R05 was deleted effective 04.01.2021.

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.

To view the complete listing of locally hosted coverage articles and/or access the Active, Future, or Retired articles available in the CMS MCD, visit the Medicare Coverage Articles webpage.


Last Updated Jan 28 , 2022