How To Use CPT Code 0134U

CPT 0134U describes the targeted mRNA sequence analysis panel for hereditary pan 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 0134U?

CPT 0134U can be used to describe the targeted mRNA sequence analysis panel for hereditary pan cancer. This code is used when analyzing a specific set of 18 genes to improve variant classification of genes associated with hereditary breast and ovarian cancer, hereditary endometrial cancer, and hereditary colorectal cancer. It is important to note that this code should be used in conjunction with other specific codes for primary procedures.

2. Official Description

The official description of CPT code 0134U is: ‘Hereditary pan cancer (eg, hereditary breast and ovarian cancer, hereditary endometrial cancer, hereditary colorectal cancer), targeted mRNA sequence analysis panel (18 genes) (List separately in addition to code for primary procedure).’ This code is used to identify and classify variants in genes associated with hereditary cancer-related disorders.

3. Procedure

1. The lab analyst performs targeted mRNA sequence analysis of 18 genes using a high-throughput, qualitative, and quantitative sequence analysis technology.
2. This analysis allows for better classification of splicing variants and improves the understanding of gene variants that may impact clinical outcomes.
3. Clinicians order this test as an adjunct to DNA genetic testing to determine the need for earlier or more frequent imaging and testing, guide medical management, and tailor treatments for hereditary cancer-related disorders.
4. The test focuses on specific genes or gene regions associated with hereditary breast, ovarian, endometrial, and colorectal cancers.
5. The results of the targeted mRNA sequence analysis help clinicians better manage cancers associated with these genes.

4. Qualifying circumstances

Patients eligible for CPT 0134U are those with suspected or confirmed hereditary breast and ovarian cancer, hereditary endometrial cancer, or hereditary colorectal cancer. This test is ordered by clinicians to improve variant classification and guide medical management for patients with these hereditary cancer-related disorders.

5. When to use CPT code 0134U

CPT code 0134U should be used when performing targeted mRNA sequence analysis of 18 genes for patients with hereditary pan cancer. This code should be used in addition to the primary procedure codes (such as 81162, 81432, or 81435) that correspond to the specific genes being analyzed.

6. Documentation requirements

To support a claim for CPT 0134U, the following documentation is required:

• Indication of the patient’s suspected or confirmed hereditary pan cancer
• Specific genes included in the targeted mRNA sequence analysis panel
• Date of the analysis
• Results of the analysis, including variant classification and any relevant findings
• Signature of the lab analyst performing the analysis

7. Billing guidelines

When billing for CPT 0134U, ensure that the test is performed by a lab offering the RNAinsight™ for CancerNext® test from Ambry Genetics. This code should only be reported in addition to the primary procedure codes (81162, 81432, or 81435) that correspond to the specific genes being analyzed. It is important to note that some payers may also separately reimburse for the collection of the specimen.

8. Historical information

CPT code 0134U 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 lab performing targeted mRNA sequence analysis of 18 genes to improve variant classification for a patient with suspected hereditary breast and ovarian cancer.
2. An oncologist ordering the RNAinsight™ for CancerNext® test to guide medical management and treatment decisions for a patient with hereditary endometrial cancer.
3. A genetic counselor utilizing targeted mRNA sequence analysis to better classify gene variants and determine the need for earlier or more frequent imaging and testing for a patient with suspected hereditary colorectal cancer.
4. A lab analyst performing targeted mRNA sequence analysis of 18 genes to identify and classify variants associated with hereditary pan cancer in a patient.
5. A clinician ordering the targeted mRNA sequence analysis panel to guide medical management and tailor treatments for a patient with confirmed hereditary breast and ovarian cancer.
6. A lab performing targeted mRNA sequence analysis to improve variant classification and identify at-risk individuals for hereditary endometrial cancer.
7. An oncologist utilizing targeted mRNA sequence analysis to determine the need for prophylactic surgical measures and guide medical management for a patient with suspected hereditary colorectal cancer.
8. A genetic counselor ordering the RNAinsight™ for CancerNext® test to identify gene variants associated with hereditary pan cancer and guide medical management for a patient.
9. A lab analyst performing targeted mRNA sequence analysis to improve variant classification and better manage hereditary breast and ovarian cancer in a patient.
10. A clinician utilizing targeted mRNA sequence analysis to guide medical management and treatment decisions for a patient with hereditary endometrial cancer.