Billing and Coding: MolDX: Pharmacogenomics Testing (A57384) - R9 - Effective April 20, 2023

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: April 20, 2023

Summary of Article Changes: Under article text added the verbiage "The character maximum for loop 2400 is 80. To prevent denials/rejects when indicating more than 80 characters, please indicate the required drug names first." under subsection heading, "Billing instructions" first paragraph.

Revised Table 1 to update to the current CPIC and FDA dates. Added new rows for ABCG2 for rosuvastatin, CYP2C19 for belzutifan, CYP2C19 for abrocitinib, CYP2C9 for nateglinide, CYP2C9 for fluvastatin, and UTGT2B17 for belzutifan.

Revised the row for SLCO1B1 to include additional generic and trade names.

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 Apr 20 , 2023