Billing and Coding: MolDX: Myriad’s BRACAnalysis CDx - R7 - Effective October 1, 2021

This Billing and Coding Article has been revised and published for notice under contract numbers: 01112 (NCA), 01182 (SCA), 01212 (AS, GU, HI, NMI), and 01312 (NV).

Effective Date: October 1, 2021
Summary of Article Changes:

Effective 10/01/2021: Under ICD-10 Codes that Support Medical Necessity Group 1: Codes added C56.3 and C79.63.

Effective 04.29.021: Under CMS National Coverage Policy added regulation Title XVIII of the Social Security Act (SSA) §1833(e), prohibits Medicare payment for any claim lacking the necessary documentation to process the claim. Under ICD-10 Codes that Support Medical Necessity Group 1: Codes deleted C25.9, C48.2, C50.911, C50.912, C50.921, C50.922, C56.9, and C79.9. Typographical errors were corrected throughout the article.

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 Fri, 05 Nov 2021 17:40:32 +0000