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June 15, 2020

Part A MolDX Claim Submission Instructions

The Molecular Diagnostic Services (MolDX) program requires a unique test ID to be submitted on a claim in addition to the CPT code for the service.

Providers billing for molecular tests performed by a proprietary or reference laboratory must obtain the 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 test ID for each molecular test in the MolDX code range. To obtain a unique test ID, register with the McKesson Diagnostics ExchangeExternal Website.

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Effective April 1, 2019, a MolDX test identification (ID) field was added to the Fiscal Intermediary Shared System (FISS) per CMS MLN Matters article MM10760External PDF.

MolDX Test ID Field Location:

837I Electronic Claim Format Direct Data Entry (DDE)
Element SV202-7 of the 2400 loop MAP171E

DDE Instructions:

  1. From Page 02 (MAP1712) of the claim, press F11 one time to access MAP171E.
  2. Key the MolDX test ID in the MOLDX field for the appropriate claim line (CL) number (i.e., the same claim line that includes the CPT code for the MolDX test on MAP1712).

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