Molecular Diagnostic Services - JE Part A

The Molecular Diagnostic Services (MolDX) Program was developed by Palmetto GBA in 2011 to identify and establish coverage and reimbursement for molecular diagnostic tests. This program performs the following functions.

• Facilitates detailed and unique identification through registration of molecular diagnostic tests to facilitate claims processing and to track utilization.
• Establishes clinical utility expectations.
• Completes technical assessments of published test data to determine clinical utility and coverage.
• Establishes reimbursement.

Palmetto Resources

• MolDX Program (Administered by Palmetto GBA)
• MolDX FAQs: Program Overview, Registration, and more
• DEX® registry

Claim Submission Reminders

• Submit only one DEX Z-Code® identifier per CPT that requires one
• Submit DEX Z-Code® identifier in Loop 2400/SV101-7
• If no DEX Z-Code® identifier is submitted, CPT will deny unprocessable
• Do not submit any other characters or test names. Doing so will slow claims processing and possibly cause incorrect denials
• NOTE: Number "0" and alpha letter "O" look very similar, check closely

Noridian’s MolDX LCDs and MolDX Articles

• Active MolDX LCDs - View all Active MolDX Local Coverage Determinations (LCDs)
• Active MolDX Billing and Coding Articles and Educational Articles - View all active MolDX Billing and Coding and Educational Articles
• Contractor Advisory Committee (CAC) - View the CAC related information
• Proposed MolDX LCDs - View all proposed MolDX LCDs
• MolDX Open Public Meetings - View all scheduled and prior MolDX Open Public Meetings

Responsibilities