Palmetto J11 Molecular Diagnostic CPT Codes Claim Submission Guidelines

Effective immediately, Palmetto J11 will require lab providers that submit claims for Molecular Diagnostic CPT codes, to include additional documentation so they can identify the provided service. For services that require more than one claim line, the additional information must appear on each line used to report the service. Additional information may be entered in the comment/narrative field. This information will be used to determine the price and the coverage for the service. If available, lab service providers may use the MolDx ID for the specific test. To facilitate this process, lab service providers may also voluntarily register a test through the MolDx test registration process.

Medicare Part A and Part B MAC for Jurisdiction 11; comprised of North Carolina, South Carolina, Virginia and West Virginia. Medicare Part A and Part B MAC for Jurisdiction 1; comprised of California, Hawaii and Nevada.