How To Use CPT Code 0171U

CPT code 0171U describes the MyMRD® NGS Panel test, which is a targeted genomic sequence analysis panel used to detect minimal residual disease (MRD) in patients with acute myeloid leukemia (AML), myelodysplastic syndrome (MDS), and myeloproliferative neoplasms (MPN). This article will provide an overview of CPT 0171U, including its official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 0171U?

CPT 0171U is a proprietary laboratory analysis (PLA) code that specifically applies to the MyMRD® NGS Panel test offered by the Laboratory for Personalized Molecular Medicine. This test utilizes next-generation sequencing (NGS) to target mutation hotspots in 23 genes associated with myeloid malignancies, such as AML, MDS, and MPN. It is designed to detect the presence or absence of minimal residual disease (MRD) in patients with these conditions.

2. Official Description

The official description of CPT code 0171U is: ‘Targeted genomic sequence analysis panel, acute myeloid leukemia, myelodysplastic syndrome, and myeloproliferative neoplasms, DNA analysis, 23 genes, interrogation for sequence variants, rearrangements and minimal residual disease, reported as presence/absence.’

3. Procedure

1. The MyMRD® NGS Panel test begins with the collection of a blood or bone marrow specimen from the patient.
2. The laboratory analyst processes the specimen to obtain purified, high-quality genomic DNA.
3. Next-generation sequencing (NGS) is performed to evaluate mutation hotspots in 23 genes associated with myeloid malignancies.
4. The test analyzes the DNA for sequence variants, rearrangements, and the presence or absence of minimal residual disease (MRD).
5. The results are evaluated against a bioinformatics database to provide diagnostic or prognostic information about treatment options or disease outcomes.
6. The test may involve algorithmic analyses to interpret the results and potentially incorporate other patient data into the analysis.

4. Qualifying circumstances

CPT code 0171U is appropriate for patients with myeloid malignancies, including AML, MDS, and MPN. It is used to detect minimal residual disease (MRD) and identify mutation combinations that may impact prognosis, reoccurrence, and treatment decisions. The test is specifically designed for the MyMRD® NGS Panel test offered by the Laboratory for Personalized Molecular Medicine.

5. When to use CPT code 0171U

CPT code 0171U should be used when ordering the MyMRD® NGS Panel test for patients with AML, MDS, or MPN to detect minimal residual disease (MRD) and assess mutation combinations relevant to the patient’s condition. It is important to note that this code should only be reported for the specific test offered by the Laboratory for Personalized Molecular Medicine and should not be reported with any other CPT code.

6. Documentation requirements

To support a claim for CPT code 0171U, the following documentation is required:

• Indication for the MyMRD® NGS Panel test in the patient’s medical record
• Documentation of the specific genes targeted by the test
• Date of service for the test
• Results of the test, including the presence or absence of minimal residual disease (MRD)
• Any additional relevant clinical information or test interpretations

7. Billing guidelines

When billing for CPT code 0171U, it is important to ensure that the test is performed by the Laboratory for Personalized Molecular Medicine and that the MyMRD® NGS Panel test is specifically ordered. This code should not be reported with any other CPT code. It is also advisable to check with the appropriate payer regarding separate payment for specimen collection.

8. Historical information

CPT code 0171U was added to the Current Procedural Terminology system on April 1, 2020. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient with AML undergoes the MyMRD® NGS Panel test to detect minimal residual disease (MRD) and assess mutation combinations relevant to their condition.
2. A patient with MDS undergoes the MyMRD® NGS Panel test to determine the presence or absence of minimal residual disease (MRD) and guide treatment decisions.
3. A patient with MPN undergoes the MyMRD® NGS Panel test to evaluate mutation hotspots in 23 genes and detect minimal residual disease (MRD) for prognostic purposes.
4. A clinician orders the MyMRD® NGS Panel test for a patient with AML to monitor treatment response and detect minimal residual disease (MRD).
5. A patient with MDS undergoes the MyMRD® NGS Panel test to assess mutation combinations and guide treatment decisions based on the presence or absence of minimal residual disease (MRD).
6. A patient with MPN undergoes the MyMRD® NGS Panel test to evaluate mutation hotspots and detect minimal residual disease (MRD) for risk stratification.
7. A clinician orders the MyMRD® NGS Panel test for a patient with AML to detect minimal residual disease (MRD) and assess response to treatment.
8. A patient with MDS undergoes the MyMRD® NGS Panel test to determine the presence or absence of minimal residual disease (MRD) and guide treatment decisions.
9. A patient with MPN undergoes the MyMRD® NGS Panel test to evaluate mutation hotspots and detect minimal residual disease (MRD) for prognostic purposes.
10. A clinician orders the MyMRD® NGS Panel test for a patient with AML to monitor treatment response and detect minimal residual disease (MRD).