How To Use CPT Code 0162U

CPT 0162U describes a targeted mRNA sequence analysis panel for hereditary colon cancer (Lynch syndrome). This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of CPT code 0162U.

1. What is CPT Code 0162U?

CPT 0162U is used to describe a targeted mRNA sequence analysis panel for hereditary colon cancer (Lynch syndrome). This code is used in conjunction with the primary procedure code to indicate the analysis of specific genes (MLH1, MSH2, MSH6, PMS2) using mRNA sequencing. The test is performed by a specific lab or manufacturer, and it provides valuable information for diagnosing and planning treatment for patients with Lynch syndrome.

2. Official Description

The official description of CPT code 0162U is: ‘Hereditary colon cancer (Lynch syndrome), targeted mRNA sequence analysis panel (MLH1, MSH2, MSH6, PMS2) (List separately in addition to code for primary procedure).’ This code is a Proprietary Laboratory Analyses (PLA) code, which means it applies to a specific lab test performed by a specific lab or manufacturer.

3. Procedure

1. The lab analyst performs a targeted mRNA sequence analysis panel for hereditary colon cancer (Lynch syndrome) using the CustomNext® + RNA: Lynch (MLH1, MSH2, MSH6, PMS2) test from Ambry Genetics®.
2. The mRNA sequencing is performed to quantify gene expression, identify novel RNA transcripts and gene fusions, and provide more accurate quantification of overlapping transcripts and allele-specific expression.
3. The analyst compares the sequence obtained from the mRNA sequencing to a reference library of normal genomes and variant gene sequences associated with Lynch syndrome.
4. The results of the targeted mRNA sequence analysis panel provide valuable diagnostic and prognostic information for the treatment of patients with Lynch syndrome.

4. Qualifying circumstances

CPT code 0162U is used for patients with hereditary non-polyposis colorectal cancer (Lynch syndrome), a type of inherited colon cancer not associated with polyposis. The test is ordered by clinicians to diagnose and plan treatment for these patients. It is important to note that this code should only be used for the specific proprietary test described and should not be reported with any other CPT code.

5. When to use CPT code 0162U

CPT code 0162U should be used when performing a targeted mRNA sequence analysis panel for hereditary colon cancer (Lynch syndrome) using the specific test mentioned. This code should be reported in addition to the primary procedure code for the full sequence analysis. It is important to use this code only for the appropriate proprietary test and not report it with any other CPT code.

6. Documentation requirements

To support a claim for CPT code 0162U, the following documentation is required:

• Indication of the patient’s diagnosis of hereditary colon cancer (Lynch syndrome)
• Specific information about the targeted mRNA sequence analysis panel performed, including the genes analyzed (MLH1, MSH2, MSH6, PMS2)
• Date of service and the results obtained from the analysis
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT code 0162U, it is important to ensure that the test is performed by the specific lab or manufacturer mentioned. This code should only be used for the targeted mRNA sequence analysis panel for hereditary colon cancer (Lynch syndrome) and should not be reported with any other CPT code. It is also recommended to check with the appropriate payer regarding payment for specimen collection, as some payers may reimburse separately for this service.

8. Historical information

CPT code 0162U was added to the Current Procedural Terminology system on January 1, 2020. There have been no updates to the code since its addition.

9. Examples

1. A lab analyst performs a targeted mRNA sequence analysis panel for MLH1, MSH2, MSH6, and PMS2 genes in a patient with a diagnosis of hereditary colon cancer (Lynch syndrome).
2. A clinician orders the CustomNext® + RNA: Lynch (MLH1, MSH2, MSH6, PMS2) test from Ambry Genetics® to diagnose and plan treatment for a patient with suspected Lynch syndrome.
3. A patient with a family history of hereditary colon cancer undergoes a targeted mRNA sequence analysis panel for MLH1, MSH2, MSH6, and PMS2 genes to determine their risk of developing Lynch syndrome.
4. A lab performs mRNA sequencing to analyze the expression of MLH1, MSH2, MSH6, and PMS2 genes in a patient with a known diagnosis of Lynch syndrome.
5. A targeted mRNA sequence analysis panel is performed on a patient’s specimen to identify any gene fusions or novel RNA transcripts associated with Lynch syndrome.
6. A clinician orders the specific targeted mRNA sequence analysis panel for hereditary colon cancer (Lynch syndrome) to guide treatment decisions for a patient with a confirmed diagnosis of Lynch syndrome.
7. A lab analyst compares the results of the targeted mRNA sequence analysis panel to a reference library of normal genomes and variant gene sequences to identify any mutations or variants associated with Lynch syndrome.
8. A patient with a family history of hereditary colon cancer undergoes mRNA sequencing to determine if they carry any mutations in MLH1, MSH2, MSH6, or PMS2 genes associated with Lynch syndrome.
9. A lab performs a targeted mRNA sequence analysis panel on a patient’s specimen to provide more accurate quantification of overlapping transcripts and allele-specific expression in MLH1, MSH2, MSH6, and PMS2 genes.
10. A clinician orders the targeted mRNA sequence analysis panel for hereditary colon cancer (Lynch syndrome) to confirm a suspected diagnosis in a patient with clinical symptoms and a family history of Lynch syndrome.