Register certain tests for phase 3 of the DEX Z-Codes

Beginning Oct. 1, you can register tests that are in scope for phase 3 of the DEX Z-Codes® for certain molecular diagnostic test services on facility and professional claims. This is part of our recently updated Molecular Pathology Reimbursement Policy, Professional and Facility, which went into effect June 1, 2024, for UnitedHealthcare commercial plans.

Claims for eligible phase 3 tests with dates of service on or after Jan. 1, 2025, need to include the appropriate Z-Codes to be considered for reimbursement.

We previously announced that the requirement for Z-Codes be included on certain molecular diagnostic testing facility and professional claims for the claims to be considered for reimbursement.

Review the codes for each phase

You can review the test codes included in phases 1–3 to ensure those are already registered.

We urge laboratories that haven’t registered with the Palmetto’s DEX® Diagnostics Exchange to begin their registration today by visiting dexzcodes.com.

Why use DEX Z-Codes?

Using the DEX Z-Code on a claim, with the appropriate CPT® code, will clearly identify the test being performed and eliminate some of the administrative burden you may encounter surrounding billing for these tests with CPT codes. This requirement applies to both facility and professional claims.

Questions?

For further guidance on the timeline for the registration of your tests, view the DEX Diagnostics Exchange test registration.

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