Coverage for Respiratory Panels (3-5 Targets)

Some good news for laboratories enrolled in the MOLDX program, passed along by Dustin Suntheimer, Vachette Pathology:

As of October 1, 2020, the MOLDX program has updated its LCDs Billing and Coding Articles to cover Respiratory Panels billed by independent laboratories under CPT code 87631 (3-5 targets). See on the bottom of page 3 of the MOLDX Local Coverage Article, under “Coding Information,” that the place of service (POS) code for Independent Laboratories (81) has been added to the POS codes for Urgent Care (20), Inpatient Hospital (21) and Emergency Room (23).

Multiplex Nucleic Amplified Tests for Respiratory Panels  L37713 LCD that include more than 5 viral pathogens are not covered, including those billed with CPT codes 87632 and 87633. The Proprietary Laboratory Analysis (PLA) Codes 0098-0099U, U100U and 0115U are no longer covered. These PLA codes represent respiratory panels using BioFire^® or GenMark^® platforms.

MOLDX is active in the following Medicare Administrative Contractors (MACs): Palmetto, Noridian, CGS and WPS.

Source: https://www.aab.org/images/aab/NILA/2020/2020107UPDATEforRPPbilling.pdf