PIK3CA Gene Tests Billing and Coding Guidelines - R4

The PIK3CA Gene Tests Billing and Coding Guidelines 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.

Summary of Changes: In Article Text, (HER2)-negative was revised to (HER2)-positive. Under ICD-10 Codes that Support Medical Necessity, Z17.1 was deleted and Z17.0 was added.
Effective Date: January 01, 2020

View the locally hosted MolDX Medicare Coverage Article PDF under Covered or Excluded Tests.

  • Go to Noridian Molecular Diagnostic Services (MolDX)  webpage.
    • The End User Agreement for Providers will appear if you have not recently visited the website. Select "Accept" (if necessary).
    • Locate and select above listed Medicare Coverage Article under Covered or Excluded Tests.

To view a complete list of Noridian coverage articles:

  • Go to the Noridian Medicare Coverage Articles webpage
  • View complete list of Noridian coverage articles
  • Access the CMS MCD to view a comprehensive revision history for this corresponding article
    • Scroll to bottom of webpage
    • Select state/contract of interest from Active, Future or Retired column (This link will redirect you to the CMS website.)
    • Once in the CMS MCD, select corresponding article title

 

            Last Updated Tue, 16 Jun 2020 19:22:45 +0000