How To Use CPT Code 0111U

CPT 0111U describes the targeted gene analysis for KRAS and NRAS codons in biopsy tissue for the detection of colon cancer. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 0111U?

CPT 0111U can be used to describe the targeted gene analysis for KRAS and NRAS codons in biopsy tissue. This code is specifically used to analyze DNA from tumor cells in formalin-fixed paraffin-embedded (FFPE) tissue samples to identify mutations in the KRAS and NRAS genes, which are known to be associated with colon cancer.

2. Official Description

The official description of CPT code 0111U is: ‘Oncology (colon cancer), targeted KRAS (codons 12, 13, and 61) and NRAS (codons 12, 13, and 61) gene analysis, utilizing formalin-fixed paraffin-embedded tissue.’

3. Procedure

1. The lab analyst performs a targeted gene analysis panel for KRAS (codons 12, 13, and 61) and NRAS (codons 12, 13, and 61) using formalin-fixed paraffin-embedded (FFPE) tissue.
2. The analysis involves using specialized equipment, such as a next-generation gene sequencer, to determine the order of nucleotides in DNA and compare the findings to a reference library of normal genomes and variant gene sequences associated with specific colon cancer mutations.
3. This procedure helps identify the genetic mutation(s) involved in colon cancer and assists clinicians in determining the appropriate treatment, specifically to decide patient eligibility for treatment with Vectibix.

4. Qualifying circumstances

CPT 0111U is used for patients who require analysis of KRAS and NRAS gene mutations in biopsy tissue to evaluate colon cancer. This test is ordered by clinicians to identify the specific genetic mutations involved in colon cancer and to determine the appropriate treatment options for the patient, including eligibility for treatment with Vectibix.

5. When to use CPT code 0111U

CPT code 0111U should be used when performing targeted gene analysis for KRAS and NRAS codons in biopsy tissue to evaluate colon cancer. This code is specifically used for the Praxis™ Extended RAS Panel from Illumina, which is a proprietary test designed for this purpose.

6. Documentation requirements

To support a claim for CPT 0111U, the following documentation is required:

• Indication of the need for targeted gene analysis for KRAS and NRAS codons in biopsy tissue
• Use of formalin-fixed paraffin-embedded (FFPE) tissue for the analysis
• Date and details of the analysis performed
• Results of the analysis, including any identified mutations in the KRAS and NRAS genes
• Signature of the lab analyst performing the analysis

7. Billing guidelines

When billing for CPT 0111U, ensure that the analysis is performed using formalin-fixed paraffin-embedded (FFPE) tissue samples. This code should only be reported for the Praxis™ Extended RAS Panel from Illumina and should not be reported with any other CPT codes. Report one unit of this code for a single specimen analyzed on a single date of service.

8. Historical information

CPT 0111U, the targeted gene analysis for KRAS and NRAS codons in biopsy tissue, was added to the Current Procedural Terminology system on October 1, 2019. There have been no updates to the code since its addition.

9. Examples

1. A patient undergoes targeted gene analysis of KRAS and NRAS codons in biopsy tissue to identify specific genetic mutations associated with colon cancer.
2. A clinician orders the Praxis™ Extended RAS Panel from Illumina for a patient with suspected colon cancer to determine the appropriate treatment options based on the identified genetic mutations.
3. A lab analyst performs targeted gene analysis for KRAS and NRAS codons in biopsy tissue to assist in the diagnosis and treatment planning for a patient with colon cancer.
4. Based on the results of the targeted gene analysis, a patient is determined to be eligible for treatment with Vectibix, a medication specifically indicated for certain genetic mutations in colon cancer.
5. A biopsy tissue sample is analyzed using the Praxis™ Extended RAS Panel from Illumina to identify the presence of KRAS and NRAS gene mutations in a patient with suspected colon cancer.
6. Targeted gene analysis is performed on biopsy tissue to evaluate the genetic mutations involved in colon cancer and guide the selection of appropriate treatment options for the patient.
7. A clinician orders CPT 0111U to analyze KRAS and NRAS codons in biopsy tissue to determine the genetic mutations associated with colon cancer in a patient.
8. The Praxis™ Extended RAS Panel from Illumina is used to perform targeted gene analysis on biopsy tissue, providing valuable information about the genetic mutations involved in colon cancer.
9. Based on the results of targeted gene analysis, a patient with colon cancer is recommended a personalized treatment plan tailored to their specific genetic mutations.
10. A lab analyst analyzes biopsy tissue using the Praxis™ Extended RAS Panel from Illumina to identify the presence of KRAS and NRAS gene mutations, aiding in the diagnosis and treatment of colon cancer.