Billing and Coding: MolDX: Molecular Biomarkers to Risk-Stratify Patients at Increased Risk for Prostate Cancer (A58724)- R5 - Effective September 11, 2024

Date Posted: January 23, 2025

This Billing and Coding Article has been revised under contractor numbers: 02102 (AK), 02202 (ID), 02302 (OR), 02402 (WA), 03102 (AZ), 03202 (MT), 03302 (ND), 03402 (SD), 03502 (UT), and 03602 (WY).

Effective Date: September 11, 2024

Summary of Changes:

Under CPT/HPCS Codes Group 1: Paragraph revised "MyProstate Score 2.0 (MPS 2.0) (PLA 0403U), performed on non-DRE urine specimens" to read "MyProstate Score 2.0 (MPS 2.0) (PLA 0403U), performed on first catch urine specimens". Under CPT/HPCS Codes Group 2:

Under CPT/HPCS Codes Group 1: Paragraph revised "MyProstate Score 2.0 (MPS 2.0) (PLA 0403U), performed on non-DRE urine specimens" to read "MyProstate Score 2.0 (MPS 2.0) (PLA 0403U), performed on first catch urine specimens". Under CPT/HPCS Codes Group 2: Paragraph revised "MyProstate Score 2.0 (MPS 2.0) (PLA 0403U), performed on non-DRE urine specimens" to read "MyProstate Score 2.0 (MPS 2.0) (PLA 0403U), performed on first catch urine specimens". This revision is due to new covered assay that has successfully completed a TA and is effective 9/11/2024.

Under CPT/HPCS Codes Group 1: Paragraph deleted "ExoDX Prostate assay (PLA 0005U), performed on non-DRE urine specimens". Under CPT/HCPCS Codes Group 1: Codes deleted 0005U. Under CPT/HPCS Codes Group 2: Paragraph deleted "ExoDX Prostate assay (PLA 0005U), performed on non-DRE urine specimens". Under CPT/HCPCS Codes Group 2: Codes deleted 0005U. These additions were done in error and is effective 12/27/2023.

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Last Updated Jan 23 , 2025