How To Use CPT Code 0217U

CPT 0217U describes a genomic DNA sequence analysis of 51 genes, including small sequence changes, deletions, duplications, short tandem repeat gene expansions, and variants in non-uniquely mappable regions. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of CPT code 0217U.

1. What is CPT Code 0217U?

CPT 0217U is a proprietary laboratory analysis (PLA) code that applies to a specific lab test called Genomic Unity® Comprehensive Ataxia Repeat Expansion and Sequence. This test is performed by Variantyx Inc. and is used for the diagnosis of ataxia, a neurological condition characterized by uncontrolled jerky movements.

2. Official Description

The official description of CPT code 0217U is: ‘Neurology (inherited ataxias), genomic DNA sequence analysis of 51 genes including small sequence changes, deletions, duplications, short tandem repeat gene expansions, and variants in non-uniquely mappable regions, blood or saliva, identification and categorization of genetic variants.’

3. Procedure

1. The lab analyst performs DNA sequencing of 51 genes and analyzes deletions, duplications, and short tandem repeat expansions associated with ataxia using a patient’s blood or saliva specimen.
2. A next-generation gene sequencer, an automated instrument, determines the order of nucleotides in DNA and generates a patient genome gene sequence.
3. Proprietary algorithms analyze the data, and an analyst interprets the results in relation to the patient’s physical characteristics.

4. Qualifying circumstances

CPT 0217U is ordered by clinicians when a patient exhibits symptoms of ataxia and the clinician wants to test for more than just the repeat expansion loci. The test analyzes 51 genes associated with ataxia, including small sequence changes, deletions, duplications, short tandem repeat gene expansions, and variants in non-uniquely mappable regions.

5. When to use CPT code 0217U

CPT code 0217U should be used when a clinician orders the Genomic Unity® Comprehensive Ataxia Repeat Expansion and Sequence test for a patient suspected of having ataxia. It should not be used for other purposes or for testing unrelated to ataxia.

6. Documentation requirements

To support a claim for CPT code 0217U, the documentation should include:

• Patient’s symptoms and indication for the test
• Details of the genes analyzed and the specific genetic variants identified
• Date and type of specimen collected (blood or saliva)
• Results of the DNA sequencing and analysis
• Interpretation of the results in relation to the patient’s physical characteristics
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT code 0217U, ensure that the test is performed by Variantyx Inc. and that it is reported only for the Genomic Unity® Comprehensive Ataxia Repeat Expansion and Sequence test. Do not report this test using any other CPT code. It is important to follow the specific guidelines provided by the payer and consider any additional requirements for specimen collection (e.g., reporting code 36415 for blood collection).

8. Historical information

CPT code 0217U was added to the Current Procedural Terminology system on October 1, 2020. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient presents with uncontrolled jerky movements, and the clinician orders the Genomic Unity® Comprehensive Ataxia Repeat Expansion and Sequence test to identify any genetic variants associated with ataxia.
2. A patient exhibits symptoms of ataxia, and the clinician wants to analyze 51 genes to determine if there are any small sequence changes, deletions, duplications, short tandem repeat gene expansions, or variants in non-uniquely mappable regions.
3. A patient has a family history of ataxia, and the clinician orders the Genomic Unity® Comprehensive Ataxia Repeat Expansion and Sequence test to assess the risk of developing the condition.
4. A patient’s symptoms suggest ataxia, and the clinician wants to rule out other genetic conditions by analyzing 51 genes associated with ataxia.
5. A patient has been diagnosed with ataxia, and the clinician orders the Genomic Unity® Comprehensive Ataxia Repeat Expansion and Sequence test to identify any specific genetic variants that may inform treatment options.
6. A patient presents with uncontrolled jerky movements and other neurological symptoms, and the clinician orders the Genomic Unity® Comprehensive Ataxia Repeat Expansion and Sequence test to aid in the diagnosis of ataxia.
7. A patient’s symptoms are consistent with ataxia, and the clinician wants to determine if there are any specific genetic variants that may impact the prognosis of the condition.
8. A patient has a family history of ataxia, and the clinician orders the Genomic Unity® Comprehensive Ataxia Repeat Expansion and Sequence test to assess the risk of passing on the condition to future generations.
9. A patient presents with uncontrolled jerky movements, and the clinician orders the Genomic Unity® Comprehensive Ataxia Repeat Expansion and Sequence test to identify any genetic variants that may be responsible for the symptoms.
10. A patient has been diagnosed with ataxia, and the clinician wants to analyze 51 genes to determine if there are any additional genetic variants that may impact the management of the condition.