How To Use CPT Code 0133U

CPT 0133U describes a targeted mRNA sequence analysis panel for hereditary prostate cancer-related disorders. 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 0133U?

CPT 0133U can be used to describe a targeted mRNA sequence analysis panel for hereditary prostate cancer-related disorders. This code is used in conjunction with code 81162 and is specific to the RNAinsight™ for ProstateNext® test from Ambry Genetics. The test analyzes 11 genes to improve the classification of variants implicated in various hereditary prostate cancer-related disorders.

2. Official Description

The official description of CPT code 0133U is: ‘Hereditary prostate cancer-related disorders, targeted mRNA sequence analysis panel (11 genes) (List separately in addition to code for primary procedure).’ This code is a proprietary laboratory analysis (PLA) code and is specific to the RNAinsight™ for ProstateNext® test from Ambry Genetics. It should be reported separately in addition to the code for the primary procedure.

3. Procedure

1. The lab analyst carries out targeted mRNA sequence analysis of 11 genes using a high throughput, qualitative, and quantitative sequence analysis technology.
2. The analysis focuses on specific genes associated with hereditary prostate cancer-related disorders.
3. The technology used, such as CloneSeq™, allows for better classification of splicing variants.
4. The test is ordered by clinicians as an adjunct to DNA genetic testing to improve variant classification and guide medical management for hereditary prostate cancer-related disorders.
5. The results of the mRNA sequence analysis help clinicians better manage cancers associated with these genes.

4. Qualifying circumstances

CPT 0133U is used for patients with hereditary prostate cancer-related disorders who require targeted mRNA sequence analysis of 11 genes. The test is ordered by clinicians to improve variant classification, identify at-risk individuals, guide medical management, and tailor treatments. The test is specific to the RNAinsight™ for ProstateNext® test from Ambry Genetics.

5. When to use CPT code 0133U

CPT code 0133U should be used when ordering the RNAinsight™ for ProstateNext® test from Ambry Genetics. It should be reported in addition to the primary procedure code, 81162, which covers the genomic sequence analysis of genes associated with hereditary prostate cancer-related disorders.

6. Documentation requirements

To support a claim for CPT code 0133U, the following documentation is required:

• Order for the RNAinsight™ for ProstateNext® test
• Results of the targeted mRNA sequence analysis of 11 genes
• Explanation of how the results impact variant classification and medical management
• Signature of the clinician ordering the test

7. Billing guidelines

When billing for CPT code 0133U, ensure that the test is performed by Ambry Genetics and is specific to the RNAinsight™ for ProstateNext® test. Report this code only in addition to the primary procedure code, 81162. It is important to note that some payers may pay separately for the collection of the specimen, so it is recommended to check with the appropriate payer.

8. Historical information

CPT code 0133U 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 clinician orders the RNAinsight™ for ProstateNext® test for a patient with a family history of hereditary prostate cancer-related disorders. The targeted mRNA sequence analysis panel of 11 genes provides additional information on variant classification and guides medical management.
2. A patient with a known hereditary prostate cancer-related disorder undergoes the RNAinsight™ for ProstateNext® test. The results of the targeted mRNA sequence analysis help the clinician tailor treatments and determine the need for earlier or more frequent imaging and testing.
3. A clinician orders the RNAinsight™ for ProstateNext® test for a patient with newly diagnosed prostate cancer. The targeted mRNA sequence analysis panel of 11 genes assists in identifying at-risk individuals and guiding medical management decisions.
4. A patient with a family history of hereditary prostate cancer-related disorders undergoes the RNAinsight™ for ProstateNext® test. The targeted mRNA sequence analysis provides additional information on variant classification, allowing the clinician to better manage the patient’s condition.
5. A clinician orders the RNAinsight™ for ProstateNext® test for a patient with a known hereditary prostate cancer-related disorder. The targeted mRNA sequence analysis panel of 11 genes helps identify at-risk individuals and guides medical management decisions.
6. A patient with a family history of hereditary prostate cancer-related disorders undergoes the RNAinsight™ for ProstateNext® test. The results of the targeted mRNA sequence analysis assist the clinician in determining the need for earlier or more frequent imaging and testing.
7. A clinician orders the RNAinsight™ for ProstateNext® test for a patient with a family history of hereditary prostate cancer-related disorders. The targeted mRNA sequence analysis panel of 11 genes provides additional information on variant classification, guiding medical management decisions.
8. A patient with a known hereditary prostate cancer-related disorder undergoes the RNAinsight™ for ProstateNext® test. The results of the targeted mRNA sequence analysis assist the clinician in tailoring treatments and determining the need for earlier or more frequent imaging and testing.
9. A clinician orders the RNAinsight™ for ProstateNext® test for a patient with newly diagnosed prostate cancer. The targeted mRNA sequence analysis panel of 11 genes helps identify at-risk individuals and guides medical management decisions.
10. A patient with a family history of hereditary prostate cancer-related disorders undergoes the RNAinsight™ for ProstateNext® test. The targeted mRNA sequence analysis provides additional information on variant classification, allowing the clinician to better manage the patient’s condition.