How To Use CPT Code 0049U

CPT 0049U describes the quantitative analysis of the NPM1 (nucleophosmin) gene, specifically for conditions such as acute myeloid leukemia. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 0049U?

CPT 0049U can be used to describe the quantitative analysis of the NPM1 gene, which is associated with conditions like acute myeloid leukemia. This code is specific to the NPM1 MRD by NGS LabPMM LLC, an Invivoscribe Technologies, Inc. Company. The test utilizes next-generation sequencing (NGS) and polymerase chain reaction (PCR) techniques to detect tumor-specific markers of the NPM1 gene. It is primarily used for post-treatment monitoring or recurrence assessment in patients with acute myeloid leukemia.

2. Official Description

The official description of CPT code 0049U is: ‘NPM1 (nucleophosmin) (eg, acute myeloid leukemia) gene analysis, quantitative.’

3. Procedure

1. The lab analyst performs technical steps, including nucleic acid extraction, amplification, and detection of the NPM1 gene mutations.

4. Qualifying circumstances

CPT 0049U is commonly ordered for patients with acute myeloid leukemia (AML), particularly those with cytogenetically normal AML (CN-AML) who do not show inherited genetic changes related to the condition. The test is designed to detect somatic mutations in the NPM1 gene, which occur during the patient’s lifetime and are not inherited.

5. When to use CPT code 0049U

CPT code 0049U should be used when performing the quantitative analysis of the NPM1 gene for patients with conditions such as acute myeloid leukemia. It is specifically intended for post-treatment monitoring or recurrence assessment. This code should not be reported with any other CPT codes for laboratory/pathology services.

6. Documentation requirements

To support a claim for CPT code 0049U, the documentation should include:

• Indication of the need for NPM1 gene analysis
• Details of the testing methodology, including NGS and PCR techniques
• Date and specific results of the analysis
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT code 0049U, ensure that the test is performed by the specific lab, LabPMM LLC, an Invivoscribe Technologies, Inc. Company. Report one unit of this code for a single specimen analyzed on a single date of service. Some payers may also provide separate reimbursement for specimen collection, so it is important to check with the appropriate payer for their specific guidelines.

8. Historical information

CPT code 0049U was added to the Current Procedural Terminology system on July 1, 2018. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient with acute myeloid leukemia undergoes post-treatment monitoring using the NPM1 gene analysis (CPT 0049U) to assess the presence of residual disease.
2. A clinician orders the quantitative analysis of the NPM1 gene (CPT 0049U) for a patient with suspected recurrence of acute myeloid leukemia.
3. Following treatment for acute myeloid leukemia, a patient undergoes regular NPM1 gene analysis (CPT 0049U) to monitor their response and detect any signs of relapse.
4. A patient with cytogenetically normal acute myeloid leukemia (CN-AML) undergoes the NPM1 gene analysis (CPT 0049U) to assess the presence of somatic mutations in the NPM1 gene.
5. During follow-up care for acute myeloid leukemia, a patient’s blood sample is analyzed using the NPM1 gene analysis (CPT 0049U) to evaluate their treatment response.
6. A clinician orders the quantitative analysis of the NPM1 gene (CPT 0049U) for a patient with suspected minimal residual disease after treatment for acute myeloid leukemia.
7. A patient with a history of acute myeloid leukemia undergoes regular NPM1 gene analysis (CPT 0049U) to monitor for any signs of disease recurrence.
8. Following treatment for acute myeloid leukemia, a patient’s blood sample is analyzed using the NPM1 gene analysis (CPT 0049U) to assess their treatment response and detect any residual disease.
9. A clinician orders the quantitative analysis of the NPM1 gene (CPT 0049U) for a patient with suspected minimal residual disease after undergoing chemotherapy for acute myeloid leukemia.
10. During routine follow-up care for acute myeloid leukemia, a patient’s blood sample is analyzed using the NPM1 gene analysis (CPT 0049U) to monitor their disease status and detect any signs of relapse.