Billing and Coding: Minimal Residual Disease Testing for Hematologic Cancers (A58997) - R5 - Effective January 1, 2024

Date Posted: February 1, 2024

This coverage article has been revised and published for notice under contract numbers: 02101 (AK), 02201 (ID), 02301 (OR), 02401 (WA), 03101 (AZ), 03201 (MT), 03301 (ND), 03401 (SD), 03501 (UT), and 03601 (WY).

Effective Date: January 1, 2024

Summary of Article Changes:

Under CPT/HCPCS Codes Group 1: Codes the description was revised for 81450. Under CPT/HCPCS Codes Group 4: Codes the description was revised for 81450. This is due to the 2024 Annual/Q1 CPT/HCPCS Code Update and is effective 1/1/2024.

Under Article Text subheading Regarding NGS panels removed "DEX Z-code" and replaced with "DEX Z-Code®". Under Article Text subheading Billing Instructions revised 1st sentence to remove "DEX™" and replaced with "DEX®". Revised 3rd and 6th bullets to remove "DEX Z-Code™" and replaced with "DEX Z-Code®". Added "NOTE: When entering the DEX Z-Code® on the SV101-7 documentation field for Part B claims please do not add additional characters and/or information on the line". Formatting was corrected throughout the article. This revision is effective 1/1/2024.

Updated Article Text verbiage with "Item".  Noridian has modified certain language in the articles 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 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 Feb 01 , 2024