Chat GPT researched MOLDX.
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Thinking longer for a better answer
Browsing and analyzing MolDx program updates
Opening and screenshotting PDF for manual analysis
Exploring history, trends, and critiques of MolDx program
I need more background on the history and perception of the MolDx program, including its 2011 origin and expansion. I'll mention its use by Medicare Advantage and commercial insurers, and details from sources like UHC PDFs and CMS MCD. I'll also look up criticisms from organizations like GAO and OIG.
Searching critiques and details on MolDX program expansion
Looking for citations on perceptions from AMP resources
I need to gather citations on perceptions, possibly from the AMP letter or other relevant sources. I'll open the AMP PDF and use screenshots to reference lines directly. Let's
Identifying authoritative sources for MolDx
I’ll explore alternative sources like a peer-reviewed article on economics, but I want more authoritative references. Maybe CMS, OIG, or GAO could provide solid insights on MolDx. I’ll search for more authoritative sources to back the information with credible, policy-related perspectives.
Searching for authoritative reports on MolDX Z-codes
Using accessible sources and screenshots for citations
I can't use that source due to a 403 error. I'll rely on accessible documents like AJMC 2014, PMC, and UHC docs for now. When citing PDFs, we need screenshots to ensure accuracy. I'll capture key sections from the MolDX manual and UHC PDF, focusing on important pages.
Taking a screenshot for UHC PDF reference
I need to take a screenshot of the UHC PDF. I’ll open the reference from the website to get the correct page for this. Once I have it, I’ll capture the necessary parts for citation.
Opening reference to search for UHC PDF
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Sources·75
- MedicareMolecular Diagnostic Services - JE Part BJul 15, 2025 — The Molecular Diagnostic Services Program (MolDX) was developed to identify and establish coverage and reimbursement for molecular ...
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- Centers for Medicare & Medicaid ServicesLCD - MolDX: Molecular Diagnostic Tests (MDT) (L36256)MolDX® will only cover and reimburse tests that demonstrate analytical and clinical validity, and clinical utility at a level that meets the Medicare reasonable ...Read more
- Centers for Medicare & Medicaid ServicesLCD - MolDX: Molecular Diagnostic Tests (MDT) (L35160)Molecular Diagnostic Services Program (MolDX®) will review all new test/assay clinical information to determine if a test meets Medicare's reasonable and ...Read more
- PMCMolecular Pathology Economics 101: An Overview of ... - PMCby AN Sireci · 2020 · Cited by 20 — In the MolDx model, each individual molecular assay is tracked by a Z code. The Z codes are unique five-character alphanumeric tracking codes ...Read more
- ascp.orgBilling & Coding: The Expanding Role of Z-CodesAug 29, 2023 — The updated policy requires providers to submit a DEX Z-Code with every molecular pathology testing code to be considered for reimbursement.Read more
- UHC ProviderFAQ: Diagnostics Exchange (DEX) Z-Code requirements for molecular diagnostic testing - UnitedHealthcare Medicare Advantage Plans
- Palmetto GBATechnical Assessment - MolDXIn order to receive favorable review results, the assay must demonstrate clinical utility (CU), fulfill the CMS "reasonable and necessary" criteria, and meet ...Read more
- palmettogba.comMolecular Diagnostic Tests and Medicare - MolDXMolDX reviews DEX Z-Code® test applications and technical assessments (TA) to confirm each test meets Medicare's reasonable and necessary criteria.Read more
- palmettogba.comMolDX - Frequently Asked QuestionsAfter 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- ...Read more
- palmettogba.comMolecular Diagnostic Program (MolDX) ManualMolecular Diagnostic Services Program (MolDX): A program designed and operated by Palmetto GBA to identify and establish coverage on existing tests, newly ...
- palmettogba.comMolDX ® Program (Administered by Palmetto GBA)MolDx The MolDX Program was developed in 2011 to identify and establish coverage and reimbursement for molecular diagnostic tests. MolDX success hinges on ...Read more
- palmettogba.comMolDX - GeneralThe Molecular Diagnostic Services Program (MolDX) was developed to identify and establish coverage and reimbursement for molecular diagnostic tests.Read more
- palmettogba.comMolDX - MoIDX Open Meeting: October 6, 2025The final LCD will be published in the CMS Medicare Coverage Database and on individual contractors' websites, allowing for a minimum of 45 days' public notice ...Read more
- palmettogba.comJurisdiction J Part B - LCD Development MeetingsThe meeting transcript and video recording are available. 1/30/2026. 1/6/2026. MolDX: Molecular Testing for Detection of Upper Gastrointestinal Metaplasia ...Read more
- palmettogba.comMolDX - 5. Claims RelatedMolDX 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 ...Read more
- palmettogba.comVast Diagnostic Testing Registry Simplifies Medicare ...Jun 7, 2024 — When a Z-Code is reported with the appropriate CPT/HCPCS code, payors can identify the exact service performed. These Z-codes are registered and ...Read more
- uhcprovider.comZ-Code requirements for molecular diagnostic testingWithin 2 weeks of adding your test into the DEX Registry, we'll assign a Z-Code to your test(s). You'll receive an email notification with your assigned Z-Code ...
- uhcprovider.comZ-Code requirements for molecular diagnostic testing DEX ...As of Dec. 1, 2024, you began registering tests that are in scope for phases 1 and 2 of the DEX · Z-Codes® for certain molecular diagnostic test services on ...Read more
- uhcprovider.comMolecular Pathology Policy, Professional and FacilityUnitedHealthcare Medicare Advantage requires providers to submit the appropriate unique test identifier (DEX Z-. Code™) for molecular diagnostic tests and other ...Read more
- uhcprovider.comZ-Code requirements for molecular diagnostic testingYes. When reporting molecular diagnostic tests you must submit a Palmetto DEX Z-Code identifier on the claim for the services to be considered for ...
- cms.govProposed LCD - MolDX: Molecular Testing for Identification ...This contractor will cover molecular diagnostic tests for use in the evaluation and management of beneficiaries suspected of having Hereditary Transthyretin ...Read more
- cms.govMolecular Diagnostic Tests (MDT) (A57526) - MolDXThe information in this article contains billing, coding, or other guidelines that complement the Local Coverage Determination (LCD) for MolDX: Molecular ...Read more
- cms.govLCD - MolDX: Molecular Diagnostic Tests (MDT) (L35025)Molecular Diagnostic Services Program (MolDX®) will review all new test/assay clinical information to determine if a test meets Medicare's reasonable and ...Read more
- cms.govMolDX: Molecular Diagnostic Tests (MDT) (A57527)Noridian has modified certain language in this article to mirror the language used presently by the MolDX team at Palmetto GBA as part of an annual review.Read more
- cms.govMolDX: Next-Generation Sequencing for Solid TumorsWe appreciate Palmetto's willingness to provide limited coverage for NGS-based testing of solid tumors in cancer patients as part of emerging efforts to both ...Read more
- cms.govLCD - MolDX: Molecular Diagnostic Tests (MDT) (L36021)MolDX® will only cover and reimburse tests that demonstrate analytical and clinical validity, and clinical utility at a level that meets the Medicare reasonable ...Read more
- cms.govMolDX: Molecular Diagnostic Tests (MDT) (A56853)... codes require a Z-code if the testing is molecular (DNA/RNA) based.” Under CPT/HCPCS Codes Group 2: added codes 81599 AND 87999. This revision is effective ...Read more
- cms.govBilling and Coding: MolDX: Molecular Syndromic Panels ...Palmetto GBA, A and B MAC, 10111 ... Tests with other indicated uses may therefore submit for a Z-code and undergo a Technical Assessment (TA) by MolDX.Read more
- cms.govMolDX: Molecular Syndromic Panels for Infectious Disease ...Apr 14, 2022 — Tests using CPT code 87999 will also require a Z-code. Laboratories that are billing for multiple individual pathogens using the 59 modifier ...Read more
- noridianmedicare.comMolecular Diagnostic Services - JF Part BJul 15, 2025 — The Molecular Diagnostic Services (MolDX) Program was developed by Palmetto GBA in 2011 to identify and establish coverage and reimbursement for molecular ...Read more
- noridianmedicare.comProposed MolDX LCDs - JE Part BWhen there are Proposed Local Coverage Determinations (LCDs) that are in the comment period, this webpage will provide a summary of comments received and ...
- noridianmedicare.comActive MolDX LCDs - JE Part B - NoridianSelect the LCD or Article number in the table below to view the policy or article on the Medicare Coverage Database (MCD).Read more
- noridianmedicare.comSearch Result - JF Part BOct 23, 2018 — The MolDX Program was developed by Palmetto GBA in 2011 to identify and establish coverage and reimbursement for molecular diagnostic tests.Read more
- xifin.com3 Ways Palmetto's MolDx Program May Jeopardize LabsNov 1, 2011 — Learn how Palmetto's MolDx Program may challenge labs with compliance issues, financial risks, and operational impacts.
- xifin.comUHC Z-Code Requirements for Commercial Test Effective ...Jan 24, 2024 — The policy will now be effective for dates of service on or after April 1, 2024 and include over 200 CPT codes in the “Wave One” of the registration.Read more
- xifin.comMastering Z-Codes for Molecular and Genetic TestsJul 28, 2023 — The lack of standardization in testing makes it difficult to know if any given test is both reasonable and necessary (or has medical necessity).Read more
- discoveriesinhealthpolicy.comNoridian, Palmetto, and the MolDx Joint Operating ...Jul 2, 2020 — The MolDX Program was developed by Palmetto GBA in 2011 to identify and establish coverage and reimbursement for molecular diagnostic tests.Read more
- dexzcodes.comDEX Diagnostics ExchangeMDx tests are uniquely identified and cataloged using DEX Z-Code® Identifiers – Palmetto GBA's unique and proprietary 5-character alpha-numeric codes assigned ...Read more
- dexzcodes.comCurrent CPT® Codes and Z-Code® Notice for Medicare ...After DEX assigns a Z-Code for a specific test, a TA may be performed, and a result determined at the completion of the assessment.Read more
- dexzcodes.comMolDX® General FAQsAfter 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- ...
- dexzcodes.comMedicare Advantage ProvidersThe following national Medicare Advantage payers have begun requiring providers to submit a DEX Z-Code® identifier for Molecular Diagnostic Test Services on ...Read more
- dexzcodes.comDEX - About UsMay 28, 2025 — When these services are applied to Medicare, the MolDX program additionally writes policy to establish “reasonable and necessary” requirements ...Read more
- dexzcodes.comDEX - General FAQsJan 7, 2026 — The MolDX Program (Administered by Palmetto GBA) is a separate program specific to certain Medicare jurisdictions.Read more
- acla.comMedicare and Medicaid ProgramsJan 27, 2025 — ” LCD MolDX: Molecular Diagnostics Tests. (MDT) (L35025), accessible here: https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid ...Read more
- acla.comJanuary 16, 2012 Dr. Elaine Jeter, ...Jan 16, 2012 — This program does not appear to be as extensive as the MolDx program that Palmetto plans for the J1 MAC region, but ACLA stands firm in its ...Read more
- avalonhcs.comThe Future of Test Specificity with Precision Genetic Test ...Jan 24, 2023 — The procedures and controls created in a very difficult environment has resulted in automated solutions that have demonstrated transparency and ...Read more
- luciddx.comMolDX to Convene Expert Medical Panel on Medicare Local ...Jul 16, 2025 — MolDX to Convene Expert Medical Panel on Medicare Local Coverage Determination (LCD) for Lucid Diagnostics' EsoGuard® Esophageal DNA Test.Read more
- lighthouselabservices.comWhat is MolDX and When Do I Need a Z-Code?Apr 19, 2025 — The Molecular Diagnostic Services (MolDX) Program was developed by Palmetto GBA in 2011 to identify and establish coverage reimbursement for molecular ...Read more
- lighthouselabservices.comUHC Medicare Advantage claims require DEX Z-codeSep 9, 2021 — The UnitedHealthcare Medicare Advantage product will now require a DEX Z-code, effective 10/1/21. Similar to Medicare, the Z-code will be submitted in the Loop ...Read more
- yahoo.comMolDX to Convene Expert Medical Panel on Medicare ...MolDX to Convene Expert Medical Panel on Medicare Local Coverage Determination (LCD) for Lucid Diagnostics' EsoGuard® Esophageal DNA Test. PR Newswire. July ...Read more
- lablue.comMolDX: Molecular Diagnostic Tests (MDT)MolDX® will only cover and reimburse tests that demonstrate analytical and clinical validity, and clinical utility at a level that meets the Medicare reasonable ...Read more
- darkintelligencegroup.comUnitedHealthcare to Require Z-codes for Genetic Test Claims“When I submit MolDX tests for Medicare benefi- ciaries, the intended population includes individuals that are 65 years and older and located in United States.Read more
- sanfordhealth.orgLCD - MolDX: Molecular Diagnostic Tests (MDT) (L36256)2022 — Molecular Diagnostic Services Program (MolDX®) will review all new test/assay clinical information to determine if a test meets Medicare's reasonable and ...Read more
- darkdaily.comMolDX and Z-identifier Codes: Why, How, and the FutureApr 30, 2025 — Upon review, a Z-code for the service is created and a TA performed. For Medicare, the results coverage decisions are made public as well as ...Read more
- darkdaily.comPreparing for Z-Codes as DEX Genetic Testing Registry ...Apr 22, 2024 — Several private insurers, including UHC, already require use of Z-Codes in their Medicare Advantage plans, but beginning June 1, UHC will be the ...Read more
- cgsmedicare.comCGS Administrators Announces MolDX Expansion to J15 ...CGS Administrators is happy to announce that we are working with the MolDx contractor, Palmetto GBA concerning Molecular Diagnostic Testing (MDT). All ...Read more
- ajmc.comNew Thinking on Clinical Utility: Hard Lessons for ...Sep 17, 2014 — Issued by McKesson (contracted technology provider for MolDx), Z-Codes offer a transparent way to identify and track unique diagnostic tests.Read more
- wpsgha.comMolDx ResourcesMar 6, 2025 — Jurisdictions: J5A J5B J8A J8B. This resource applies to the J5A, J5B, J8A and J8B regions, however your selected region is . WPS continues ...Read more
- telcor.comUnitedHealthcare Stresses Compliance With Z-Code ...Mar 4, 2024 — UnitedHealthcare (UHC) will enforce compliance with new DEX Z-code requirements for molecular diagnostic testing on April 1.Read more
- amp.orgOctober 30, 2013 Marilyn Tavenner Administrator Centers ...Oct 30, 2013 — We have serious concerns with the MolDX program and the inconsistencies of the program with the established LCD process. The LCD is recognized ...Read more
- oup.comPayer reimbursement practices and incentives for improving ...by P Deverka · 2023 · Cited by 9 — One reason that code stacking is still frequently used is that the payment rates are frequently much higher and more likely to be covered than a specific MGPT ...Rea...
- onclive.comHow Test Reimbursement Decisions Are Made: A Leader ...Oct 21, 2014 — As part of its Medicare Administrative Contract, MolDX has developed a program for the registration and medical-necessity review of molecular/ ...Read more
- dmepdac.comMolDX ® Program (Administered by Palmetto GBA)To access and obtain a DEX Z-Code®, go to the DEX® Diagnostics Exchange Registry. If you are a provider not billing for Medicare services within the MolDX ...Read more
- researchgate.net(PDF) The laboratory billing process and its applications to ...Oct 9, 2025 — In this review, we provide a comprehensive overview of laboratory billing processes for insurance billing and hospital inpatient services, as ...Read more
- streamlinesci.comMolDx FAQThe MolDX program was developed by Palmetto GBA to identify and establish coverage and reimbursement standards for molecular diagnostic tests.Read more
- ascp.orgBilling & Coding: The Expanding Role of Z-CodesAug 29, 2023 — Complying with the new policy will be easier for labs that already have Z-Codes under the MolDX program as there is a reported backlog in the ...Read more
- ascp.orgBilling & Coding: The Expanding Role of Z-CodesAug 29, 2023 — The updated policy requires providers to submit a DEX Z-Code with every molecular pathology testing code to be considered for reimbursement.Read more
- ascp.orgBilling & Coding: The Expanding Role of Z-CodesAug 29, 2023 — The updated policy requires providers to submit a DEX Z-Code with every molecular pathology testing code to be considered for reimbursement.Read more
- revenulytics.comUnderstanding the MolDx Program: An Essential GuideMay 13, 2024 — This program has been specifically designed to manage the coverage and reimbursement of molecular diagnostic tests (MDx) provided to Medicare beneficiaries.Read more
- pathologywatch.comMedicare Local Coverage Determination PolicyMolDX® will only cover and reimburse tests that demonstrate analytical and clinical validity, and clinical utility at a level that meets the. Medicare ...Read more
- device.reportMolDX Manual... Palmetto GBA, a weekly Master Edit File (MEF). In addition to the MEF, Palmetto GBA will coordinate appropriate LCD development and provide educational ...Read more
- mypreferredprovider.com2025-unitedhealthcare-care-provider-administrative-guide- ...Welcome to the UnitedHealthcare Care Provider Administrative Guide for Commercial and Medicare Advantage. (MA) products. This guide has important ...Read more
- mmplusinc.comThe Molecular Diagnostic Services (MolDX) ProgramNov 7, 2017 — Established FDA-approved tests with proven utility that are performed within labeling indications may not require a technical assessment. A TA ...Read more
- helixmolecularsolutions.comUHC's Z-Code Requirement Delay: A Window of ...Jul 20, 2023 — Although Z-codes have been a requirement for molecular tests covered under
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