Laboratory Question for the Week of August 14, 2017

Laboratory Compliance Question of the Week

Question:

What codes would be reported for targeted genomic sequence analysis?

Answer:

CPT® codes 81445, 81450, and 81455 (partial descriptors below) describe targeted genomic sequence analyses. The codes differ based on the type of neoplasm (hematolymphoid or solid organ) and the number of genes analyzed. Medicare payment policy requires that a physician report only one of these codes for a hematolymphoid or solid-organ neoplasm on a single date of service depending upon the total number of genes analyzed.

81445 Targeted genomic sequence analysis panel, solid organ neoplasm, DNA analysis, and RNA analysis when performed, 5-50 genes …, interrogation for sequence variants and copy number variants or rearrangements, if performed
81450 Targeted genomic sequence analysis panel, hematolymphoid neoplasm or disorder, DNA analysis, and RNA analysis when performed, 5-50 genes…, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mRNA expression levels, if performed
81455 Targeted genomic sequence analysis panel, solid organ or hematolymphoid neoplasm, DNA analysis, and RNA analysis when performed, 51 or greater genes …, interrogation for sequence variants and copy number variants or rearrangements, if performed

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Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.