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IMPORTANT: THIS DOCUMENT CONTAINS OUTDATED INFORMATION.

Content provided on this page contains outdated information and instruction and should not be considered current. CGS is providing this archived information for research purposes only. This archived section contains previously issued instructions that have since been updated or are no longer applicable for Medicare billing purposes.

October 5, 2015 - Revised: 09.30.16

bioTheranostics Cancer TYPE ID (CM00015, V4)

Effective November 19, 2012, Cancer TYPE ID, an RT-PCR 92-gene assay, has been assigned a new identifier to reflect the changes in the test. To bill for Cancer TYPE ID services, please provide the following claim information:

Claims received prior to 01/01/2016: CPT code 81479 – unlisted molecular pathology procedure
Claims received 01/01/2016 and forward CPT code 81540 - Oncology (tumor of unknown origin) mRNA gene expression of 92 genes
Enter '1' in the Days/Unit field
Enter Z-Code™ Identifier in the comment/narrative field for the following claim field/types:
- Loop 2300 NTE01 for Part A or Loop 2400 or SV101-7 field for Part B
- Submit Z-Code™ Identifier on an attachment to the claim form for paper claim (Form locator 80 for Part A or Box 19 for Part B)
Select the appropriate diagnosis code:
- ICD-9-CM Code:
  - 153.5 Malignant Neoplasm of Appendix Vermiformis
  - 153.9 Malignant Neoplasm of Colon Unspecified Site
  - 155.0 Malignant Neoplasm of Liver Primary
  - 155.2 Malignant Neoplasm of Liver Not Specified As Primary or Secondary
  - 157.2 Malignant Neoplasm of Tail of Pancreas
  - 157.8 Malignant Neoplasm of Other Specified Sites of Pancreas
  - 157.9 Malignant Neoplasm of Pancreas Part Unspecified
  - 158.0 Malignant Neoplasm of Retroperitoneum
  - 162.0 Malignant Neoplasm of Trachea
  - 162.2 Malignant Neoplasm of Main Bronchus
  - 162.3 Malignant Neoplasm of Upper Lobe Bronchus or Lung
  - 162.5 Malignant Neoplasm of Lower Lobe Bronchus or Lung
  - 162.8 Malignant Neoplasm of Other Parts of Bronchus or Lung
  - 162.9 Malignant Neoplasm of Bronchus and Lung Unspecified
  - 171.0 Malignant Neoplasm of Connective and Other Soft Tissue of Head Face and Neck
  - 171.9 Malignant Neoplasm of Connective and Other Soft Tissue Site Unspecified
  - 172.5 Malignant Melanoma of Skin of Trunk Except Scrotum
  - 174.4 Malignant Neoplasm of Upper-Outer Quadrant of Female Breast
  - 174.5 Malignant Neoplasm of Lower-Outer Quadrant of Female Breast
  - 174.8 Malignant Neoplasm of Other Specified Sites of Female Breast
  - 174.9 Malignant Neoplasm of Breast (Female) Unspecified Site
  - 183.0 Malignant Neoplasm of Ovary
  - 185 Malignant Neoplasm of Prostate
  - 188.5 Malignant Neoplasm of Bladder Neck
  - 188.9 Malignant Neoplasm of Bladder Part Unspecified
  - 189.0 Malignant Neoplasm of Kidney Except Pelvis
  - 195.0 Malignant Neoplasm of Head Face and Neck
  - 196.0 - 196.9 Secondary and Unspecified Malignant Neoplasm of Lymph Nodes of Head Face and Neck - Secondary and Unspecified Malignant Neoplasm of Lymph Nodes Site Unspecified
  - 197.0 Secondary Malignant Neoplasm of Lung
  - 197.5 Secondary Malignant Neoplasm of Large Intestine and Rectum
  - 197.6 Secondary Malignant Neoplasm of Retroperitoneum and Peritoneum
  - 197.7 Malignant Neoplasm of Liver Secondary
  - 198.0 Secondary Malignant Neoplasm of Kidney
  - 198.2 Secondary Malignant Neoplasm of Skin
  - 198.3 Secondary Malignant Neoplasm of Brain and Spinal Cord
  - 198.5 Secondary Malignant Neoplasm of Bone and Bone Marrow
  - 198.6 Secondary Malignant Neoplasm of Ovary
  - 198.89 Secondary Malignant Neoplasm of Other Specified Sites
  - 199.0 Disseminated Malignant Neoplasm
  - 199.1 Other Malignant Neoplasm of Unspecified Site
  - 202.87 Other Malignant Lymphomas Involving Spleen
  - 230.8 Carcinoma In Situ of Liver and Biliary System
  - 230.9 Carcinoma In Situ of Other and Unspecified Digestive Organs
  - 231.2 Carcinoma In Situ of Bronchus and Lung
  - 239.0 Neoplasm of Unspecified Nature of Digestive System
  - 239.1 Neoplasm of Unspecified Nature of Respiratory System
  - 239.2 Neoplasm of Unspecified Nature of Bone Soft Tissue and Skin
  - 239.3 Neoplasm of Unspecified Nature of Breast
  - 239.4 Neoplasm of Unspecified Nature of Bladder
  - 239.5 Neoplasm of Unspecified Nature of Other Genitourinary Organs
  - 239.6 Neoplasm of Unspecified Nature of Brain
  - 239.7 Neoplasm of Unspecified Nature of Endocrine Glands and Other Parts of Nervous System
  - 239.89 Neoplasms of Unspecified Nature, Other Specified Sites
  - 239.9 Neoplasm of Unspecified Nature Site Unspecified
  - 511.81 Malignant Pleural Effusion
- ICD-10-CM codes:
  - C18.1-Malignant neoplasm of appendix
  - C18.9-Malignant neoplasm of colon, unspecified
  - C22.0-Liver cell carcinoma
  - C22.2-Hepatoblastoma
  - C22.3-Angiosarcoma of liver
  - C22.4-Other sarcomas of liver
  - C22.7-Other specified carcinomas of liver
  - C22.8-Malignant neoplasm of liver, primary, unspecified as to type
  - C22.9-Malignant neoplasm of liver, not specified as primary or secondary
  - C25.2-Malignant neoplasm of tail of pancreas
  - C25.7-Malignant neoplasm of other parts of pancreas
  - C25.8-Malignant neoplasm of overlapping sites of pancreas
  - C25.9-Malignant neoplasm of pancreas, unspecified
  - C48.0-Malignant neoplasm of retroperitoneum
  - C33-Malignant neoplasm of trachea
  - C34.01-Malignant neoplasm of right main bronchus
  - C34.02-Malignant neoplasm of left main bronchus
  - C34.11-Malignant neoplasm of upper lobe, right bronchus or lung
  - C34.12-Malignant neoplasm of upper lobe, left bronchus or lung
  - C34.31-Malignant neoplasm of lower lobe, right bronchus or lung
  - C34.32-Malignant neoplasm of lower lobe, left bronchus or lung
  - C34.2-Malignant neoplasm of middle lobe, bronchus or lung
  - C34.81-Malignant neoplasm of overlapping sites of right bronchus and lung
  - C34.82-Malignant neoplasm of overlapping sites of left bronchus and lung
  - C34.91-Malignant neoplasm of unspecified part of right bronchus or lung
  - C34.92-Malignant neoplasm of unspecified part of left bronchus or lung
  - C47.0-Malignant neoplasm of peripheral nerves of head, face and neck
  - C49.0-Malignant neoplasm of connective and soft tissue of head, face and neck
  - C47.9-Malignant neoplasm of peripheral nerves and autonomic nervous system, unspecified
  - C49.9-Malignant neoplasm of connective and soft tissue, unspecified
  - C43.51-Malignant melanoma of anal skin
  - C43.52-Malignant melanoma of skin of breast
  - C43.59-Malignant melanoma of other part of trunk
  - D03.51-Melanoma in situ of anal skin
  - D03.52-Melanoma in situ of breast (skin) (soft tissue)
  - D03.59-Melanoma in situ of other part of trunk
  - C50.411-Malignant neoplasm of upper-outer quadrant of right female breast
  - C50.412-Malignant neoplasm of upper-outer quadrant of left female breast
  - C50.511-Malignant neoplasm of lower-outer quadrant of right female breast
  - C50.512-Malignant neoplasm of lower-outer quadrant of left female breast
  - C50.811-Malignant neoplasm of overlapping sites of right female breast
  - C50.812-Malignant neoplasm of overlapping sites of left female breast
  - C50.911- Malignant neoplasm of unspecified site of right female breast
  - C50.912- Malignant neoplasm of unspecified site of right female breast
  - C56.1- Malignant neoplasm of right ovary
  - C56.2- Malignant neoplasm of left ovary
  - C61- Malignant neoplasm of prostate
  - C67.5- Malignant neoplasm of bladder neck
  - C67.9- Malignant neoplasm of bladder, unspecified
  - C64.1- Malignant neoplasm of right kidney, except renal pelvis
  - C64.2- Malignant neoplasm of left kidney, except renal pelvis
  - C76.0- Malignant neoplasm of head, face and neck
  - C77.0- Secondary and unspecified malignant neoplasm of lymph nodes of head, face and neck
  - C77.1- Secondary and unspecified malignant neoplasm of intrathoracic lymph nodes
  - C77.2- Secondary and unspecified malignant neoplasm of intra-abdominal lymph nodes
  - C77.3- Secondary and unspecified malignant neoplasm of axilla and upper limb lymph nodes
  - C77.4- Secondary and unspecified malignant neoplasm of inguinal and lower limb lymph nodes
  - C77.5- Secondary and unspecified malignant neoplasm of intrapelvic lymph nodes
  - C77.8- Secondary and unspecified malignant neoplasm of lymph nodes of multiple regions
  - C77.9- Secondary and unspecified malignant neoplasm of lymph node, unspecified
  - C78.01- Secondary malignant neoplasm of right lung
  - C78.02- Secondary malignant neoplasm of left lung
  - C78.5- Secondary malignant neoplasm of large intestine and rectum
  - C78.6- Secondary malignant neoplasm of retroperitoneum and peritoneum
  - C78.7- Secondary malignant neoplasm of liver and intrahepatic bile duct
  - C79.01- Secondary malignant neoplasm of right kidney and renal pelvis
  - C79.02- Secondary malignant neoplasm of left kidney and renal pelvis
  - C79.2- Secondary malignant neoplasm of skin
  - C79.31- Secondary malignant neoplasm of brain
  - C79.49- Secondary malignant neoplasm of other parts of nervous system
  - C79.51- Secondary malignant neoplasm of bone
  - C79.52- Secondary malignant neoplasm of bone marrow
  - C79.61- Secondary malignant neoplasm of right ovary
  - C79.62- Secondary malignant neoplasm of left ovary
  - C79.89- Secondary malignant neoplasm of other specified sites199.0 Disseminated Malignant Neoplasm
  - C80.0-Disseminated malignant neoplasm, unspecified
  - C45.9-Mesothelioma, unspecified
  - C80.1-Malignant (primary) neoplasm, unspecified
  - C82.57-Diffuse follicle center lymphoma, spleen
  - C84.97-Mature T/NK-cell lymphomas, unspecified, spleen
  - C84.A7-Cutaneous T-cell lymphoma, unspecified, spleen
  - C84.Z7-Other mature T/NK-cell lymphomas, spleen
  - C85.17-Unspecified B-cell lymphoma, spleen
  - C85.27-Mediastinal (thymic) large B-cell lymphoma, spleen
  - C85.87-Other specified types of non-Hodgkin lymphoma, spleen
  - C85.97-Non-Hodgkin lymphoma, unspecified, spleen
  - C86.1-Hepatosplenic T-cell lymphoma (Alpha-beta and gamma delta types)
  - D01.5-Carcinoma in situ of liver, gallbladder and bile ducts
  - D01.7-Carcinoma in situ of other specified digestive organs
  - D01.9-Carcinoma in situ of digestive organ, unspecified
  - D02.21-Carcinoma in situ of right bronchus and lung
  - D02.22-Carcinoma in situ of left bronchus and lung
  - D49.0-Neoplasm of unspecified behavior of digestive system
  - D49.1-Neoplasm of unspecified behavior of respiratory system
  - D49.2-Neoplasm of unspecified behavior of bone, soft tissue, and skin
  - D49.3-Neoplasm of unspecified behavior of breast
  - D49.4-Neoplasm of unspecified behavior of bladder
  - D49.5-Neoplasm of unspecified behavior of other genitourinary organs (end dated 09/30/2016)
  - D49.511-Neoplasm of unspecified behavior right kidney
  - D49.512-Neoplasm of unspecified behavior left kidney
  - D49.6-Neoplasm of unspecified behavior of brain
  - D49.7-Neoplasm of unspecified behavior of endocrine glands and other parts of nervous system
  - D49.89-Neoplasm of unspecified behavior of other specified sites
  - D49.9-Neoplasm of unspecified behavior of unspecified site
  - J91.0-Malignant pleural effusion

Note: MolDX expects this test to ONLY be ordered by the treating physician.

License for Use of "Physicians' Current Procedural Terminology", (CPT) Fourth Edition

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POINT AND CLICK LICENSE FOR USE OF "CURRENT DENTAL TERMINOLOGY", ("CDT")

bioTheranostics Cancer TYPE ID (CM00015, V4)

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