How To Use CPT Code 0229U

CPT 0229U describes a proprietary laboratory analysis (PLA) code for BCAT1 and IKZF1 promoter methylation analysis. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of CPT code 0229U.

1. What is CPT Code 0229U?

CPT 0229U is a unique laboratory test code that is used for BCAT1 and IKZF1 promoter methylation analysis. This test is performed on a blood specimen from a patient who has been treated for colorectal cancer. The purpose of the test is to analyze the methylation (silencing) of these two genes, which are associated with colorectal tumor tissue. The results of the test can be used by clinicians to evaluate the presence of residual disease or monitor for recurrent cancer.

2. Official Description

The official description of CPT code 0229U is: ‘BCAT1 (Branched chain amino acid transaminase 1) and IKZF1 (IKAROS family zinc finger 1) (eg, colorectal cancer) promoter methylation analysis.’

3. Procedure

1. The lab analyst extracts DNA from patient plasma.
2. Bisulfite conversion is performed to distinguish methylated and unmethylated products.
3. DNA is amplified by polymerase chain reaction (PCR) to determine the presence of methylation of BCAT1 and IKZF1 genes.
4. Methylation within certain loci of these genes indicates the presence of colorectal cancer.

4. Qualifying circumstances

CPT code 0229U is used for patients who have been treated for colorectal cancer and need to be evaluated for residual disease or monitored for recurrent cancer. The test analyzes the methylation of BCAT1 and IKZF1 genes, which are associated with colorectal tumor tissue. It is important to note that this code is specific to the Colvera® test from Colvera Clinical Genomics Pathology Inc.

5. When to use CPT code 0229U

CPT code 0229U should be used when clinicians order the Colvera® test for patients who have been treated for colorectal cancer. The test is used to evaluate the presence of residual disease or monitor for recurrent cancer. It is important to note that this code should only be used for the specific proprietary test and not for any other similar tests.

6. Documentation requirements

To support a claim for CPT code 0229U, the following documentation is required:

• Indication of the patient’s previous treatment for colorectal cancer
• Explanation of the need for the Colvera® test
• Date of the test
• Results of the test indicating the methylation status of BCAT1 and IKZF1 genes
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT code 0229U, it is important to ensure that the test is performed using the Colvera® test from Colvera Clinical Genomics Pathology Inc. This code should only be reported for a single specimen analyzed on a single date of service. It is also important to check with the appropriate payer to determine if they will pay separately for the collection of the specimen.

8. Historical information

CPT code 0229U was added to the Current Procedural Terminology system on January 1, 2021. There have been no updates to the code since its addition. It is important to note that this code is part of the proprietary laboratory analysis (PLA) codes, which take precedence over the usual 80000 series codes for laboratory/pathology.

9. Examples

1. A patient who has been treated for colorectal cancer undergoes the Colvera® test to evaluate the presence of residual disease.
2. A clinician orders the Colvera® test for a patient who has completed treatment for colorectal cancer to monitor for recurrent cancer.
3. The Colvera® test is performed on a blood specimen from a patient who has undergone surgery for colorectal cancer to determine the methylation status of BCAT1 and IKZF1 genes.
4. A patient with a history of colorectal cancer undergoes the Colvera® test to assess the effectiveness of their treatment.
5. A clinician orders the Colvera® test for a patient who has completed chemotherapy for colorectal cancer to determine if there is any residual disease.
6. The Colvera® test is performed on a blood specimen from a patient who has undergone radiation therapy for colorectal cancer to monitor for recurrent cancer.
7. A patient who has completed treatment for colorectal cancer undergoes the Colvera® test to detect any early signs of recurrence.
8. A clinician orders the Colvera® test for a patient who has a family history of colorectal cancer to assess their risk of developing the disease.
9. The Colvera® test is performed on a blood specimen from a patient who has undergone targeted therapy for colorectal cancer to evaluate the effectiveness of the treatment.
10. A patient with a history of colorectal cancer undergoes the Colvera® test to determine if there is any residual disease after their treatment.