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 10, 2022

Summary of Article Changes:

Under Article Text added the verbiage: “Refer to Billing and Coding: MolDX: Molecular Diagnostic Tests (MDT) A57526 for CPT/HCPCS Codes that are applicable to this article” after the first sentence. Under CPT/HCPCS Codes Group 1: Paragraph deleted the verbiage and moved it to the end of the Article Text section. Under CPT/HCPCS Codes Group 1: Codes deleted all codes. Deleted CPT/HCPCS Codes Group 2: Paragraph, CPT/HCPCS Codes Group 2: Codes, and CPT/HCPCS Modifiers Group 2: Codes.

12/17/2021: Under CPT/HCPCS Modifiers: added 59 modifier to group 2. Noridian has modified certain language in this article to mirror the language used presently by the MolDX team at Palmetto GBA as part of an annual review. Revision history dates and language may not exactly match the MolDX PGBA revision history. However, these revisions do not change coverage or guidance.

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.