How To Use CPT Code 0160U
CPT 0160U describes a specific laboratory test called MSH6 mRNA sequence analysis, which is used in conjunction with the primary procedure code 81298. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of CPT code 0160U.
1. What is CPT Code 0160U?
CPT 0160U is a proprietary laboratory analysis (PLA) code that applies to a unique lab test performed by a specific manufacturer or lab. It is used to report the CustomNext® + RNA: MSH6 from Ambry Genetics®, which involves mRNA sequence analysis of the MSH6 gene. This test is performed after the full sequence analysis of the MSH6 gene to quantify gene expression, identify novel RNA transcripts and gene fusions, and provide more accurate quantification of overlapping transcripts and allele-specific expression.
2. Official Description
The official description of CPT code 0160U is: ‘MSH6 (mutS homolog 6) (eg, hereditary colon cancer, Lynch syndrome) mRNA sequence analysis (List separately in addition to code for primary procedure).’ This code is used in conjunction with the primary procedure code 81298, which covers the full sequence analysis of the MSH6 gene.
3. Procedure
- After performing the full sequence analysis of the MSH6 gene, the lab analyst proceeds with mRNA sequencing to quantify gene expression, identify novel RNA transcripts and gene fusions, and provide more accurate quantification of overlapping transcripts and allele-specific expression.
4. Qualifying circumstances
CPT 0160U is used for patients with hereditary colon cancer (Lynch syndrome), a type of inherited colorectal cancer not associated with polyposis. Clinicians order this test to diagnose and plan treatment for these patients. It is important to note that this test should be performed by the specific lab or manufacturer associated with the CustomNext® + RNA: MSH6 test.
5. When to use CPT code 0160U
CPT code 0160U should be used when the CustomNext® + RNA: MSH6 test is performed in conjunction with the primary procedure code 81298. This code should only be reported for the specific proprietary test described and should not be reported with any other CPT code.
6. Documentation requirements
To support a claim for CPT code 0160U, the documentation should include:
- Indication for performing the test, such as a diagnosis of hereditary colon cancer or Lynch syndrome
- Documentation of the full sequence analysis of the MSH6 gene
- Date and specific results of the mRNA sequence analysis
- Signature of the lab analyst performing the test
7. Billing guidelines
When billing for CPT code 0160U, ensure that the test is performed by the specific lab or manufacturer associated with the CustomNext® + RNA: MSH6 test. Report one unit of this code for a single specimen analyzed on a single date of service. It is important to check with the appropriate payer regarding payment for specimen collection. This test should not be reported with any other CPT code.
8. Historical information
CPT code 0160U was added to the Current Procedural Terminology system on January 1, 2020. There have been no updates or changes to the code since its addition.
9. Examples
- A patient with a family history of hereditary colon cancer undergoes the full sequence analysis of the MSH6 gene, followed by the CustomNext® + RNA: MSH6 test to assess gene expression and identify any novel RNA transcripts or gene fusions.
- A clinician orders the CustomNext® + RNA: MSH6 test for a patient with Lynch syndrome to better understand the gene expression patterns and allele-specific expression of the MSH6 gene.
- After performing the full sequence analysis of the MSH6 gene, the lab analyst proceeds with the mRNA sequence analysis using the CustomNext® + RNA: MSH6 test to provide more accurate quantification of overlapping transcripts and allele-specific expression.
