Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing: (A58726) - R22 - Effective September 13, 2024

Date Posted: December 5, 2024

This Billing and Coding Article has been revised under contractor numbers: 02101 (AK), 02201 (ID), 02301 (OR), 02401 (WA), 03101 (AZ), 03201 (MT), 03301 (ND), 03401 (SD), 03501 (UT), and 03601 (WY).

Effective Date: September 13, 2024

Summary of Changes:

Under CPT/HCPCS Codes Group 12: Paragraph added "Onychomycosis Panels: This code is only reimbursed for patients with a confirmed histopathologic diagnosis of an infiltrative/invasive fungal onychomycosis and whose culture (and antifungal susceptibility) of the nail is negative or cannot be performed." Under CPT/HCPCS Codes Group 12: Codes added 87999. Under CPT/HCPCS Modifiers Group 12: Codes added 59. Under ICD-10 Codes that Support Medical Necessity Group 12: Paragraph added "These are the diagnosis codes corresponding to coverage of CPT/ HCPCS Codes Group 12: Codes-Onychomycosis Panels." Under ICD-10 Codes that Support Medical Necessity Group 12: Codes added B35.1. This revision is effective 9/13/2024.

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Last Updated Dec 05 , 2024