What is procedure code 81401?
What is procedure code 81401?
CPT® Code 81401 – Tier 2 Molecular Pathology Procedures – Codify by AAPC. CPT. Pathology and Laboratory Procedures. Molecular Pathology Procedures.
What are Tier 2 molecular pathology procedures?
Tier 2 molecular pathology procedures represent procedures that are generally performed in lower volumes than Tier 1 molecular pathology procedures (e.g., the incidence of the disease being tested is rare).
What CPT codes are used for genetic testing?
Providers should refer to the current CPT book for applicable CPT codes.
| Code | Description |
|---|---|
| 81231 | Cyp3a5 gene common variants |
| 81232 | Dpyd gene common variants |
| 81233 | Btk gene common variants |
| 81234 | Dmpk gene detc abnor allele |
Is CPT 81241 covered by Medicare?
This testing is considered investigational and is NOT a Medicare benefit.
What is unlisted molecular pathology procedure?
Unlisted codes provide the means of reporting and tracking services until a more specific code is established. If no such specific code exists, reporting the service using the appropriate unlisted service code would be appropriate. The service should be adequately documented in the medical record.
What is the CPT code for BRCA testing?
CPT 81166: BRCA1 (BRCA1, DNA repair associated) (e.g., hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (i.e., detection of large gene rearrangements); this tests a single gene in an assay.
What are Tier 2 codes?
Tier 2 codes are intended to report a wide range of molecular pathology procedures for which Tier 1 or other test-specific CPT codes have not been assigned. Tier 2 codes are organized and assigned based of level of technical and interpretive effort required.
What is a molecular pathology procedure Level 4?
This code is for molecular pathology procedure, Level 4 (for example, analysis of single exon by DNA sequence analysis, analysis of >10 amplicons using multiplex PCR in 2 or more independent reactions, mutation scanning or duplication/deletion variants of 2-5 exons).
What is the code for paternity test?
Paternity Testing
| CPT Code | Description |
|---|---|
| 86910 | Blood typing, typing for paternity testing, per individual; ABO, Rh and MN |
| 86911 | Blood typing, for paternity testing, per individual, ABO, Rh and MN; each additional antigen system |
Does Medicare cover next generation sequencing?
In 2018, Medicare issued a national coverage determination (NCD) providing reimbursement for next-generation sequencing (NGS) tests for beneficiaries with advanced or metastatic cancer and no previous NGS testing.
Who is required to bill a PLA code?
PLA codes are alpha-numeric CPT® codes with a corresponding descriptor, for labs or manufacturers to more specifically identify their test. Tests with PLA codes must be performed on human specimens and must be requested by the clinical laboratory or manufacturer that offers the test.
