How To Use CPT Code 0135U

CPT 0135U describes the targeted mRNA sequence analysis panel for hereditary gynecological 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 0135U?

CPT 0135U can be used to describe a targeted mRNA sequence analysis panel for hereditary gynecological cancer. This code is used when analyzing 12 specific genes to improve variant classification and better understand the genes associated with various hereditary gynecological cancers.

2. Official Description

The official description of CPT code 0135U is: ‘Hereditary gynecological cancer (eg, hereditary breast and ovarian cancer, hereditary endometrial cancer, hereditary colorectal cancer), targeted mRNA sequence analysis panel (12 genes) (List separately in addition to code for primary procedure).’ This code is used in conjunction with code 81162 for genomic sequence analysis of genes associated with hereditary breast, ovarian, endometrial, and other hereditary cancer-related disorders.

3. Procedure

1. The lab analyst performs targeted mRNA sequence analysis of 12 genes using a high-throughput, qualitative, and quantitative sequence analysis technology.
2. This analysis allows for better classification of splicing variants and provides valuable information about the genes implicated in hereditary gynecological cancers.
3. Clinicians order this test as an adjunct to DNA genetic testing to improve variant classification and identify at-risk individuals.
4. The test helps determine the need for earlier or more frequent imaging and testing, prophylactic surgical measures, and tailored medical management for patients with hereditary gynecological cancers.
5. The results of the mRNA sequence analysis guide medical decision-making and treatment options for patients with these cancers.

4. Qualifying circumstances

Patients eligible for CPT 0135U are those with a family history of hereditary gynecological cancers or patients with family members who have multiple different primaries. This test is ordered by clinicians to improve variant classification, identify at-risk individuals, and guide medical management and treatment options for patients with hereditary breast, ovarian, endometrial, and other gynecological cancers.

5. When to use CPT code 0135U

CPT code 0135U should be used when performing targeted mRNA sequence analysis of 12 genes to improve variant classification for hereditary gynecological cancers. This code should be reported in addition to the primary procedure code (81162) for genomic sequence analysis of genes associated with hereditary cancer-related disorders.

6. Documentation requirements

To support a claim for CPT 0135U, documentation should include:

• Indication for the test, such as a family history of hereditary gynecological cancers
• Specific genes analyzed in the targeted mRNA sequence analysis panel
• Date of service and results of the analysis
• Implications of the analysis for medical management and treatment options
• Signature of the clinician ordering the test

7. Billing guidelines

When billing for CPT 0135U, ensure that the test is performed by a laboratory offering the RNAinsight™ for GYNPlus® test from Ambry Genetics. This code should be reported in addition to the primary procedure code (81162). It is important to note that some payers may also separately reimburse for specimen collection, so it is advisable to check with the appropriate payer.

8. Historical information

CPT 0135U was added to the Current Procedural Terminology system on October 1, 2019. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient with a family history of hereditary breast and ovarian cancer undergoes targeted mRNA sequence analysis of 12 genes to improve variant classification and guide medical management.
2. A clinician orders the RNAinsight™ for GYNPlus® test for a patient with a family history of hereditary endometrial cancer to better understand the genes associated with this condition and tailor treatment options.
3. A patient with a family history of hereditary colorectal cancer undergoes targeted mRNA sequence analysis of 12 genes to identify at-risk individuals and guide medical decision-making.
4. A clinician orders CPT 0135U for a patient with a family history of multiple different primaries to improve variant classification and determine the need for earlier or more frequent imaging and testing.
5. A patient with a family history of hereditary gynecological cancers undergoes targeted mRNA sequence analysis of 12 genes to better understand the genetic factors contributing to their condition and guide medical management.
6. A clinician orders the RNAinsight™ for GYNPlus® test for a patient with a family history of hereditary breast cancer to identify specific gene variants and tailor treatment options accordingly.
7. A patient with a family history of hereditary ovarian cancer undergoes targeted mRNA sequence analysis of 12 genes to improve variant classification and determine the need for prophylactic surgical measures.
8. A clinician orders CPT 0135U for a patient with a family history of hereditary endometrial cancer to better understand the genes implicated in this condition and guide medical decision-making.
9. A patient with a family history of hereditary colorectal cancer undergoes targeted mRNA sequence analysis of 12 genes to identify at-risk individuals and tailor medical management and treatment options.
10. A clinician orders the RNAinsight™ for GYNPlus® test for a patient with a family history of hereditary gynecological cancers to better understand the genetic factors contributing to their condition and guide medical management.