How To Use CPT Code 0179U

CPT 0179U describes the targeted sequence analysis of 23 genes in non-small cell lung cancer (NSCLC) using cell-free DNA (cfDNA). 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 0179U?

CPT 0179U can be used to analyze cell-free DNA from a blood specimen to identify possible appropriate therapies for patients with advanced metastatic non-small cell lung cancer (NSCLC). The test evaluates 23 genes for single nucleotide variations, insertions and deletions, fusions, and copy number variations that may indicate potential treatment options for the patient.

2. Official Description

The official description of CPT code 0179U is: ‘Oncology (non-small cell lung cancer), cell-free DNA, targeted sequence analysis of 23 genes (single nucleotide variations, insertions and deletions, fusions without prior knowledge of partner/breakpoint, copy number variations), with report of significant mutation(s).’

3. Procedure

1. A blood specimen is collected from the patient.
2. The cell-free DNA is extracted from the blood specimen.
3. The extracted DNA is amplified and small probes are used to capture circulating tumor DNA for analysis.
4. The targeted sequence analysis is performed on 23 genes, looking for single nucleotide variations, insertions and deletions, fusions, and copy number variations.
5. A report is generated, indicating any significant mutations found in the analyzed genes.

4. Qualifying circumstances

CPT 0179U is appropriate for patients with advanced metastatic non-small cell lung cancer (NSCLC) who may benefit from targeted therapies. The test is ordered by clinicians to determine if the patient is a candidate for specific treatment options based on the identified mutations in the analyzed genes. It is important to note that this test is specific to the Resolution ctDx Lung™ test from Resolution Bioscience Inc.

5. When to use CPT code 0179U

CPT code 0179U should be used when evaluating cell-free DNA from patients with advanced metastatic non-small cell lung cancer (NSCLC) to identify potential appropriate therapies. This code is specific to the Resolution ctDx Lung™ test and should not be reported using any other CPT code.

6. Documentation requirements

To support a claim for CPT code 0179U, the following documentation is required:

• Patient’s diagnosis of advanced metastatic non-small cell lung cancer (NSCLC)
• Date of the blood specimen collection
• Report of the targeted sequence analysis of the 23 genes
• Identification of any significant mutations found in the analyzed genes

7. Billing guidelines

When billing for CPT code 0179U, ensure that the test is performed using the Resolution ctDx Lung™ test from Resolution Bioscience Inc. Report one unit of this code for a single specimen analyzed on a single date of service. It is important to note that some payers may separately reimburse for the collection of the blood specimen using a different code, such as 36415. This code should not be reported with any other CPT code for the same test.

8. Historical information

CPT code 0179U 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 advanced metastatic non-small cell lung cancer (NSCLC) undergoes the Resolution ctDx Lung™ test, which identifies a significant mutation in one of the analyzed genes, indicating a potential targeted therapy.
2. A clinician orders the Resolution ctDx Lung™ test for a patient with advanced metastatic non-small cell lung cancer (NSCLC) to determine if there are any significant mutations that may guide treatment decisions.
3. The Resolution ctDx Lung™ test is performed on a blood specimen from a patient with advanced metastatic non-small cell lung cancer (NSCLC), revealing no significant mutations in the analyzed genes, indicating the need for alternative treatment approaches.
4. A patient with advanced metastatic non-small cell lung cancer (NSCLC) undergoes the Resolution ctDx Lung™ test, which identifies multiple significant mutations in the analyzed genes, providing valuable information for personalized treatment options.
5. A clinician orders the Resolution ctDx Lung™ test for a patient with advanced metastatic non-small cell lung cancer (NSCLC) to determine if there are any specific mutations that may indicate potential targeted therapies.
6. The Resolution ctDx Lung™ test is performed on a blood specimen from a patient with advanced metastatic non-small cell lung cancer (NSCLC), revealing a fusion without prior knowledge of partner/breakpoint, indicating a potential targeted therapy.
7. A patient with advanced metastatic non-small cell lung cancer (NSCLC) undergoes the Resolution ctDx Lung™ test, which identifies copy number variations in the analyzed genes, providing insights into potential treatment options.
8. A clinician orders the Resolution ctDx Lung™ test for a patient with advanced metastatic non-small cell lung cancer (NSCLC) to determine if there are any significant mutations that may guide the selection of appropriate therapies.
9. The Resolution ctDx Lung™ test is performed on a blood specimen from a patient with advanced metastatic non-small cell lung cancer (NSCLC), revealing no significant mutations in the analyzed genes, indicating the need for further evaluation and consideration of alternative treatment options.
10. A patient with advanced metastatic non-small cell lung cancer (NSCLC) undergoes the Resolution ctDx Lung™ test, which identifies a single nucleotide variation in one of the analyzed genes, indicating a potential targeted therapy.