Billing and Coding: MolDX: Multiplex Nucleic Acid Amplified Tests for Respiratory Viral Panels - R7

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.

Effective Date: July 30, 2020
Summary of Article Changes:
Article Text: Removed the verbiage from the second bullet point and added the verbiage “If the test does have a PLA code then submit the appropriate code.” Removed the verbiage from the third bullet point and added the verbiage “Per the MolDX: Multiplex Nucleic Acid Amplified Tests for Respiratory Viral Panels LCD, tests that include more than 5 viral pathogens are non-covered. Included in this are 87632, 87633, and additional PLA codes listed in the CPT/HCPCS Codes Group 2: Codes section of this Billing and Coding article.”
CPT/HCPCS Codes Group 1 paragraph: Added the word “only” and removed the verbiage “by a provider of any medical specialty for whom the ordering of this test is within the provider’s scope of practice and institutional privileges” from the second sentence.
CPT/HCPCS Codes Group 1 paragraph: Added the word “only” and removed the verbiage “by a provider of any medical specialty for whom the ordering of this test is within the provider’s scope of practice and institutional privileges” from the second sentence.

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 Mon, 24 Aug 2020 16:16:08 +0000