July 10, 2015 - Revised 01.04.19
MoPath: GeneSight® Assay for Refractory Depression Claims Submission Reminders
The Medical Review department has noticed an increase in claim submissions for GeneSight® with referrals from specialties other than licensed psychiatrists. As indicated in LCD L35443 MolDX: GeneSight Assay for Refractory Depression, this test should only be ordered/referred by a licensed psychiatrist. If any other specialty orders/refers this test, it will be considered not medically necessary.
To ensure your claims are processed in the most efficient manner, please enter the name of the test (GeneSight) in the narrative/comment section on electronic claims in loop 2400 NTE02 for Part B. For paper claims, submit the test name in Item 19 for Part B. A payable ICD-10 code, if appropriate, is needed for payment consideration.