Billing and Coding: MolDX: Pharmacogenomics Testing (A57384) - R13 - Effective January 25, 2024

Date Posted: January 25, 2024

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: January 25, 2024

Summary of Article Changes:

Under Article Text subheading Billing Instructions revised 1st paragraph to add "For Part B paper claims, the drug or drugs in consideration for use that require the use of the pharmacogenomics (PGx) test must be submitted in Item 19 field." This revision is effective 1/25/2024.

Under CPT/HCPCS Group 1: Codes added 0380U. This revision is due to new covered panel that has successfully completed a TA and is effective 5/11/2023.

Visit the Noridian Medicare Coverage Articles webpage to view the complete listing of coverage articles and/or access the Active, Future, or Retired articles available in the CMS MCD.

Last Updated Jan 25 , 2024