By forcing labs to obtain a Z code prior to submission of any claim and by defining tests with non-coverage as investigational, Palmetto is effectively attempting to close the loop for providers utilizing the appeal process to obtain coverage.
With the MolDx program guidelines, Palmetto's second LCD (Non-standardized organ panels) targeting Molecular Diagnostics tests by eliminating any coding that requires more than one CPT code to report, is even more deliberate in its attempt to eliminate adherence to established coding guidelines and consequently, the use of the Medicare laboratory and physician fee schedules.
