Article Detail - JE Part B
Billing and Coding: MolDX: Targeted and Comprehensive Genomic Profile Next-Generation Sequencing Testing in Cancer - R5 - Effective June 24, 2021
This coverage 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: June 24, 2021
Summary of Changes:
- Under CPT/HCPCS Codes Group 2: Codes added 0244U. This revision is due to the Q2 2021 CPT/HCPCS Code Update and is effective for dates of service on or after 4/1/2021.
- Under Article Text subsection Targeted Panels revised second paragraph to read “Effective July 1, 2017, laboratories with 2 to 4 genes on their targeted NGS panel should use CPT 81479 and one (1) UOS along with their test identifier (DEX Z-CodeTM) to represent this service on their claims” and moved second sentence to end of article text.
- Under ICD-10 Codes that Support Medical Necessity Group 1: Codes deleted D46.4, D47.9, D72.829, and D75.9.
- Under ICD-10 Codes that Support Medical Necessity Group 2: Codes deleted C00.2, C00.5, C00.6, C00.9, C02.3, C02.9, C03.9, C04.9, C05.9, C06.80, C06.9, C08.9, C09.9, C10.9, C11.9, C13.9, C14.0, C15.9, C16.5, C16.6, C16.9, C17.9, C18.9, C21.0, C22.8, C24.9, C25.9, C26.0, C31.9, C32.9, C34.00, C34.10, C34.30, C34.80, C34.90, C34.91, C34.92, C38.3, C39.0, C39.9, C40.00, C40.10, C40.20, C40.30, C40.80, C40.90, C40.91, C40.92, C41.9, C43.10, C43.20, C43.30, C43.60, C43.70, C43.9, C4A.10, C4A.20, C4A.30, C4A.60, C4A.70, C4A.9, C44.00, C44.101, C44.1021, C44.1022, C44.1091, C44.1092, C44.111, C44.121, C44.191, C44.201, C44.202, C44.209, C44.211, C44.221, C44.291, C44.300, C44.301, C44.309, C44.310, C44.320, C44.390, C44.40, C44.500, C44.501, C44.509, C44.601, C44.602, C44.609, C44.611, C44.621, C44.691, C44.701, C44.702, C44.709, C44.711, C44.721, C44.791, C44.80, C44.90, C44.91, C44.92, C44.99, C45.9, C47.10, C47.20, C47.6, C47.9, C48.2, C49.10, C49.20, C49.6, C49.9, C49.A0, C50.019, C50.029, C50.119, C50.129, C50.219, C50.229, C50.319, C50.329, C50.419, C50.429, C50.519, C50.529, C50.619, C50.629, C50.819, C50.829, C50.911, C50.912, C50.919, C50.921, C50.922, C50.929, C51.9, C53.9, C54.9, C55, C56.9, C57.00, C57.10, C57.20, C57.4, C57.9, C60.9, C62.00, C62.10, C62.90, C62.91, C62.92, C63.00, C63.10, C63.9, C64.9, C65.9, C66.9, C67.9, C68.9, C69.00, C69.10, C69.20, C69.30, C69.40, C69.50, C69.60, C69.80, C69.90, C69.91, C69.92, C70.9, C71.9, C72.20, C72.30, C72.40, C72.50, C72.9, C74.00, C74.10, C74.90, C74.91, C74.92, C75.8, C75.9 C7A.00, C7A.019, C7A.029, C7A.094, C7A.095, C7A.096, C76.40, C76.50, C80.0, and C80.1
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Last Updated Wed, 23 Jun 2021 17:50:07 +0000