How To Use CPT Code 0006M

CPT 0006M describes the mRNA expression levels of 161 genes in hepatocellular carcinoma tumor tissue, along with the alpha-fetoprotein level. It utilizes a risk classifier algorithm to report the results. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 0006M?

CPT 0006M can be used to describe the mRNA expression levels of 161 genes in fresh hepatocellular carcinoma tumor tissue. This code also includes the measurement of alpha-fetoprotein levels. The test utilizes an algorithmic analysis to report a risk classifier score based on patient data and the lab test results.

2. Official Description

The official description of CPT code 0006M is: ‘Oncology (hepatic), mRNA expression levels of 161 genes, utilizing fresh hepatocellular carcinoma tumor tissue, with alpha-fetoprotein level, algorithm reported as a risk classifier.’

3. Procedure

1. The lab analyst performs the technical lab tests for alpha-fetoprotein and mRNA gene expression profiling for 161 genes using fresh hepatocellular carcinoma tumor tissue.
2. The lab analyst inputs the test results and patient information into a computer program to analyze the data using a specific algorithm.
3. An algorithmic analysis is performed to generate a risk classifier score based on the lab test results and patient data.
4. The risk classifier score is reported as the result of the test.

4. Qualifying circumstances

CPT 0006M is typically ordered by clinicians to assess the likelihood of aggressive hepatocellular carcinoma in patients. It is not limited to testing for a specific condition, but it helps in determining the risk of high-grade prostate cancer. The test is performed using fresh hepatocellular carcinoma tumor tissue, and the results are reported using an algorithmic analysis.

5. When to use CPT code 0006M

CPT code 0006M should be used when there is a need to assess the mRNA expression levels of 161 genes in fresh hepatocellular carcinoma tumor tissue. It is appropriate for patients who may have aggressive hepatocellular carcinoma and want to avoid unnecessary biopsies. The test provides valuable information for treatment options and disease outcomes.

6. Documentation requirements

To support a claim for CPT 0006M, the documentation should include:

• Patient information and relevant clinical data
• Lab test results for alpha-fetoprotein and mRNA gene expression profiling
• Details of the algorithmic analysis performed
• The risk classifier score reported as a result

7. Billing guidelines

When billing for CPT 0006M, ensure that the test is performed using fresh hepatocellular carcinoma tumor tissue and includes the analysis of mRNA expression levels of 161 genes and alpha-fetoprotein levels. It is important to follow the specific guidelines provided by the payer and use the appropriate codes for any additional services or procedures performed in conjunction with CPT 0006M.

8. Historical information

CPT 0006M was added to the Current Procedural Terminology system on January 1, 2015. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient with suspected hepatocellular carcinoma undergoes CPT 0006M to assess the mRNA expression levels of 161 genes in their tumor tissue and determine the risk of aggressive cancer.
2. A clinician orders CPT 0006M for a patient with elevated alpha-fetoprotein levels to further evaluate the risk of hepatocellular carcinoma.
3. A patient with a family history of hepatocellular carcinoma undergoes CPT 0006M as a preventive measure to assess their risk of developing the disease.
4. A patient with a previous diagnosis of hepatocellular carcinoma undergoes CPT 0006M to monitor the mRNA expression levels of 161 genes and assess the effectiveness of their treatment.
5. A clinician orders CPT 0006M for a patient with suspicious liver lesions to determine the risk of hepatocellular carcinoma and guide further diagnostic and treatment decisions.
6. A patient with a history of hepatocellular carcinoma recurrence undergoes CPT 0006M to monitor the mRNA expression levels of 161 genes and detect any signs of disease progression.
7. A clinician orders CPT 0006M for a patient with an indeterminate liver biopsy to provide additional information and help determine the appropriate course of treatment.
8. A patient with a known genetic mutation associated with hepatocellular carcinoma undergoes CPT 0006M to assess their individual risk and guide personalized treatment decisions.
9. A clinician orders CPT 0006M for a patient with suspected metastatic hepatocellular carcinoma to assess the mRNA expression levels of 161 genes and determine the extent of the disease.
10. A patient with a history of hepatocellular carcinoma undergoes CPT 0006M as part of a surveillance program to monitor for any signs of recurrence or progression.