Z-Codes for Medicaid (Data File)

Optum |


product image

CALL 1-800-464-3649, Option 1

Item #: ZCODEM
Available: NOW







For access to the DEX® Registry and molecular diagnostic test identification

This new data and registry solution is a molecular diagnostic (MDx) test identification and policy management solution that connects payers and labs to bring clarity to MDx testing.   

MDx tests are uniquely identified and cataloged using DEX Z-Code® Identifiers — Palmetto GBA’s unique and proprietary 5-character alphanumeric codes assigned within the DEX Diagnostics Exchange. The test registry catalog is available for reference and review by other stakeholders in the health care system. A Z-Code is not just an “administrative identifier.” Z-Codes are a commitment to establishing test quality through a multifaceted process. No other genetic identifier has an established, scalable test quality component leveraged by CMS with a large national adoption rate. Health plans who purchase a Z-Code® license are purchasing access to proprietary data contained in the DEX® Registry. The license includes a payer user role on the DEX Registry website and DEX data files.

Call us today to learn how your organization can benefit from access to this vital data. Available only from Optum, the exclusive commercial distributor of Z-Code data and solutions, in partnership with Palmetto GBA.

Note: DEX® Z-Codes, as outlined in the DEX Diagnostics Exchange Registry, are unique identifiers used to facilitate the transparent sharing of test information between labs and payers. These codes are specific to the DEX platform and are essential for the registration and billing of diagnostic tests. In contrast, ICD-10 z codes categorize reasons for healthcare encounters that do not involve a diagnosis of illness or injury, such as factors influencing health status and contact with health services. They serve entirely different purposes and are not interchangeable.

Palmetto GBA configures health plans with “payer user roles” (and additional administrative role(s) for managing access) in the DEX Registry website: DEX Diagnostics Exchange Registry.  

1. Ability to browse the lab tests catalog by DEX Z-Code identifiers, CPT® code or other key word.  

2. View test details including:  
  • DEX Z-Codes 
  • Recommended CPT® code 
  • Palmetto coverage, Technical Assessment (TA) result, rationale for all tests that have been reviewed (not just MolDX) 
  • Genes, variants and other data not available to the public 
  • Lab test ID/code 
  • Test description
  • Test name
  • Lab name and additional facilities 
  • MolDx price 
  • Other: FDA number, specimen, handling, patient instructions (if applicable)  
3. View Z-Codes for all statuses (active, inactive, in review)  

4. Payer dashboard to view new participating labs, new lab tests.

5. A Z-Code mapping file containing detailed test information as submitted by the lab will be delivered by Optum.