Billing and Coding: MolDX: Pharmacogenomics Testing (A57385) - R13 - Effective January 25, 2024

Date Posted: January 25, 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 25, 2024

Summary of Article Changes:

Under Article Text subheading Billing Instructions revised 1st paragraph to add "For Part B paper claims, the drug or drugs in consideration for use that require the use of the pharmacogenomics (PGx) test must be submitted in Item 19 field." This revision is effective 1/25/2024.

Under CPT/HCPCS Group 1: Codes added 0380U. This revision is due to new covered panel that has successfully completed a TA and is effective 5/11/2023.

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Last Updated Jan 25 , 2024