How To Use CPT Code 0172U

CPT 0172U describes a specific laboratory analysis test called myChoice® CDx, which is performed by Myriad Genetics Laboratories. This test is used to determine the homologous recombination deficiency (HRD) status in patients with solid organ tumors, specifically ovarian cancer. In this article, we will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and provide examples of when to use CPT code 0172U.

1. What is CPT Code 0172U?

CPT 0172U is a proprietary laboratory analysis (PLA) code that applies to the myChoice® CDx test from Myriad Genetics Laboratories. This test is used to determine the homologous recombination deficiency (HRD) status in patients with solid organ tumors, specifically ovarian cancer. It involves the analysis of somatic mutations in the BRCA1 and BRCA2 genes, as well as the assessment of genomic instability score using a formalin-fixed paraffin-embedded tissue sample.

2. Official Description

The official description of CPT code 0172U is: ‘Oncology (solid tumor as indicated by the label), somatic mutation analysis of BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) and analysis of homologous recombination deficiency pathways, DNA, formalin-fixed paraffin-embedded tissue, algorithm quantifying tumor genomic instability score.’

3. Procedure

1. The laboratory analyst performs next-generation sequencing-based testing using formalin-fixed paraffin-embedded tissue of solid organ tumors.
2. The specimen undergoes multiple steps, including fragmentation, end repair and adenylation, adapter ligation, amplification, hybridization, sequencing, and data analysis.
3. The test detects sequence variants and genomic rearrangements in the BRCA1 and BRCA2 genes, as well as analyzes genomic instability.
4. The results are reported, including BRCA1 and BRCA2 variant classification, genomic instability classification, and the calculated genomic instability score.

4. Qualifying circumstances

CPT code 0172U is used for patients with ovarian cancer who require assessment of their homologous recombination deficiency (HRD) status. The test specifically analyzes somatic mutations in the BRCA1 and BRCA2 genes, which are associated with breast and ovarian cancer, as well as other cancers. The presence of clinically significant variants in these genes or a positive genomic instability calculation supports the use of certain therapies.

5. When to use CPT code 0172U

CPT code 0172U should be used when ordering the myChoice® CDx test from Myriad Genetics Laboratories to determine the HRD status in patients with ovarian cancer. It should not be reported using any other CPT code, as it is a proprietary laboratory analysis (PLA) code specific to this test.

6. Documentation requirements

To support a claim for CPT code 0172U, the documentation should include:

• Indication for the test, such as ovarian cancer
• Details of the formalin-fixed paraffin-embedded tissue sample used
• Steps performed during the testing process
• Results of the somatic mutation analysis of BRCA1 and BRCA2
• Genomic instability score and classification
• Signature of the laboratory analyst performing the test

7. Billing guidelines

When billing for CPT code 0172U, ensure that the test is performed by Myriad Genetics Laboratories for the myChoice® CDx test. Report one unit of this code for a single specimen analyzed on a single date of service. Any additional preparation work, such as tissue selection or microdissection, should be separately reported if documented. This code should not be reported with any other CPT code for laboratory/pathology services.

8. Historical information

CPT code 0172U was added to the Current Procedural Terminology system on July 1, 2020. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient with ovarian cancer undergoes the myChoice® CDx test to determine their homologous recombination deficiency (HRD) status.
2. A physician orders CPT code 0172U for a formalin-fixed paraffin-embedded tissue sample from a patient with ovarian cancer to assess their genomic instability score.
3. A laboratory analyst performs the myChoice® CDx test on a specimen from a patient with ovarian cancer, detecting somatic mutations in the BRCA1 and BRCA2 genes and calculating the genomic instability score.
4. A positive HRD status is identified in a patient with ovarian cancer through the myChoice® CDx test, guiding the selection of appropriate therapies.
5. A patient with ovarian cancer undergoes the myChoice® CDx test, which reveals clinically significant variants in the BRCA1 and BRCA2 genes, indicating a potential benefit from certain treatments.
6. A formalin-fixed paraffin-embedded tissue sample from a patient with ovarian cancer is analyzed using the myChoice® CDx test, providing a genomic instability score and classification.
7. A physician orders CPT code 0172U for a patient with ovarian cancer to assess their homologous recombination deficiency (HRD) status using the myChoice® CDx test.
8. A laboratory analyst performs the myChoice® CDx test on a formalin-fixed paraffin-embedded tissue sample from a patient with ovarian cancer, analyzing somatic mutations in the BRCA1 and BRCA2 genes and calculating the genomic instability score.
9. The myChoice® CDx test is used to determine the HRD status in a patient with ovarian cancer, providing valuable information for treatment decision-making.
10. A patient with ovarian cancer undergoes the myChoice® CDx test, which detects somatic mutations in the BRCA1 and BRCA2 genes and assesses their genomic instability score.