5. Claims Related

After DEX® assigns a Z-Code for a specific test, a Technical Assessment (TA) is performed, and a result determined at the completion of the assessment. The Z-Code is effective and can be submitted on claims once the test has been assigned a TA result and has been assigned a recommended CPT® code.

• For tests that do not require additional TA documentation, this is complete in approximately 3-4 weeks.
• For tests that have submitted additional TA documentation, this process can take up to 60 days.

Once the TA review process is complete, you will receive an email notification and the TA evaluation result will be updated in the DEX Registry.

MolDX is not able to address claims related questions. Please contact your payer MAC directly for assistance.

The DEX Z-Code identifier is only additional information, not a billing code.

MolDX will reimburse tests that fulfill coverage criteria in valid policy, which requires successful completion of a TA and a valid Z-Code submitted with the claim. The effective date for reimbursement will be the date the successful TA was received by MolDX. Labs are instructed to hold claims during the TA review period. If the TA is successful, you can be reimbursed for services performed during the review period.