November 29, 2016 - Updated 12.12.22
Part A MolDX Claim Submission Instructions (CM00098, V2)
Effective March 1, 2017, all molecular tests in the MolDX code ranges designated below must submit Part A claims using a Z-identifier in addition to the billing CPT code. Providers who submit claims on the UB04 claim form must use block 80 to submit Z-identifiers, and for electronic claims, the Z-identifier must be reported on line SV-202-7 of the 837I. Failure to submit the Z-identifier per the MolDX code ranges will result in claim rejection, effective 3/1/2017. A test description will no longer be accepted to identify the specific test billed.
Providers billing for molecular tests performed by a proprietary or reference laboratory must obtain the Z-identifier for the molecular test(s) from the performing laboratory. Part A providers billing for molecular services performed by a hospital-based laboratory must register and obtain a unique Z-identifier for each molecular test in the MolDX code range that follows, please see L36021 Molecular Diagnostic Tests (MDT) policy article for codes.
To obtain a Z-identifier, register with the Diagnostics Exchange™. Each molecular test billed to Part A requires a Z-identifier.
To allow MolDX to correctly apply coverage and reimbursement for molecular tests, please enter the following information for each test submitted on the claim:
- Enter claim line number of the performed test
- Enter registered test ID, if available
- If ID is unavailable, enter short descriptor
Correct Notepad Samples:
| Sample 1: ID for a test on line number one | Line 1- ZB123 |
| Sample 2: IDs for two molecular tests on line one and line two | Line 1- ZB123 Line 2- ZD456 |
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