How To Use CPT Code 0245U

CPT 0245U describes the ThyGeNEXT® Thyroid Oncogene Panel by Interpace Diagnostics, which is a proprietary laboratory analysis (PLA) code. This code is used to analyze 10 genes, 37 RNA fusions, and the expression of four mRNA markers using next-generation sequencing (NGS) on a fine needle aspirate (FNA) specimen from the thyroid. The report generated from this test includes the associated risk of malignancy expressed as a percentage. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of CPT code 0245U.

1. What is CPT Code 0245U?

CPT 0245U is a proprietary laboratory analysis (PLA) code that specifically describes the ThyGeNEXT® Thyroid Oncogene Panel by Interpace Diagnostics. This test utilizes next-generation sequencing (NGS) to analyze 10 genes, 37 RNA fusions, and the expression of four mRNA markers in a fine needle aspirate (FNA) specimen from the thyroid. The results of this analysis provide valuable information about the risk of malignancy associated with the tested specimen, which is expressed as a percentage.

2. Official Description

The official description of CPT code 0245U is: ‘Oncology (thyroid), mutation analysis of 10 genes and 37 RNA fusions and expression of 4 mRNA markers using next-generation sequencing, fine needle aspirate, report includes associated risk of malignancy expressed as a percentage.’

3. Procedure

1. The lab analyst receives a fine needle aspirate (FNA) specimen from the thyroid for analysis.
2. Next-generation sequencing (NGS) is performed on the specimen to analyze mutations in 10 genes, 37 RNA fusions, and the expression of four mRNA markers.
3. An algorithmic analysis is conducted using the test results and patient data to evaluate the risk of malignancy associated with the tested specimen.
4. The report generated from the analysis includes the risk of malignancy expressed as a percentage.

4. Qualifying circumstances

CPT code 0245U is typically ordered by clinicians when evaluating patients with indeterminate thyroid nodule cytopathology using a fine needle aspirate (FNA) specimen. This test helps determine the likelihood of thyroid cancer, identify possible aggressive forms, and assists clinicians in making decisions regarding thyroid surgery or other interventions. It is important to note that CPT code 0245U is a proprietary laboratory analysis (PLA) code and should only be used for the specific ThyGeNEXT® Thyroid Oncogene Panel test offered by Interpace Diagnostics.

5. When to use CPT code 0245U

CPT code 0245U should be used when a clinician orders the ThyGeNEXT® Thyroid Oncogene Panel test by Interpace Diagnostics to analyze a fine needle aspirate (FNA) specimen from the thyroid. This test is particularly useful when evaluating patients with indeterminate thyroid nodule cytopathology to assess the risk of malignancy. It is important to ensure that the test is performed by Interpace Diagnostics and that the results include the associated risk of malignancy expressed as a percentage.

6. Documentation requirements

To support a claim for CPT code 0245U, the following documentation is typically required:

• Indication for ordering the ThyGeNEXT® Thyroid Oncogene Panel test
• Details of the fine needle aspirate (FNA) specimen analyzed
• Results of the next-generation sequencing (NGS) analysis, including mutations in 10 genes, 37 RNA fusions, and the expression of four mRNA markers
• Algorithmic analysis of the test results and patient data
• Reported risk of malignancy expressed as a percentage
• Signature of the lab analyst performing the analysis

7. Billing guidelines

When billing for CPT code 0245U, it is important to ensure that the test is performed by Interpace Diagnostics and that the report includes the associated risk of malignancy expressed as a percentage. As a proprietary laboratory analysis (PLA) code, CPT code 0245U takes precedence over the usual 80000 series codes for laboratory/pathology. It should not be reported using any other CPT code. It is also important to follow any additional guidelines provided by the payer regarding the billing of PLA codes.

8. Historical information

CPT code 0245U, the ThyGeNEXT® Thyroid Oncogene Panel by Interpace Diagnostics, was added to the Current Procedural Terminology system on April 1, 2021. As a relatively new code, there have been no updates or changes to the code since its addition.

9. Examples

1. A clinician orders the ThyGeNEXT® Thyroid Oncogene Panel test by Interpace Diagnostics to evaluate the risk of malignancy in a fine needle aspirate (FNA) specimen from a patient with an indeterminate thyroid nodule cytopathology.
2. A patient undergoes the ThyGeNEXT® Thyroid Oncogene Panel test by Interpace Diagnostics on a fine needle aspirate (FNA) specimen from their thyroid to assess the risk of malignancy and determine the need for further interventions.
3. A clinician utilizes the ThyGeNEXT® Thyroid Oncogene Panel test by Interpace Diagnostics to analyze a fine needle aspirate (FNA) specimen from a patient’s thyroid and receive a report that includes the associated risk of malignancy expressed as a percentage.
4. A patient with indeterminate thyroid nodule cytopathology undergoes the ThyGeNEXT® Thyroid Oncogene Panel test by Interpace Diagnostics to obtain information about the risk of malignancy and guide treatment decisions.
5. A clinician orders the ThyGeNEXT® Thyroid Oncogene Panel test by Interpace Diagnostics for a patient with an indeterminate thyroid nodule cytopathology to determine the likelihood of thyroid cancer and identify potential aggressive forms.
6. A fine needle aspirate (FNA) specimen from a patient’s thyroid is analyzed using the ThyGeNEXT® Thyroid Oncogene Panel test by Interpace Diagnostics to evaluate the risk of malignancy and provide valuable information for clinical decision-making.
7. A clinician utilizes the ThyGeNEXT® Thyroid Oncogene Panel test by Interpace Diagnostics to assess the risk of malignancy in a fine needle aspirate (FNA) specimen from a patient’s thyroid and make informed decisions regarding further diagnostic or therapeutic interventions.
8. A patient with indeterminate thyroid nodule cytopathology undergoes the ThyGeNEXT® Thyroid Oncogene Panel test by Interpace Diagnostics to obtain a report that includes the associated risk of malignancy expressed as a percentage and guide treatment planning.
9. A clinician orders the ThyGeNEXT® Thyroid Oncogene Panel test by Interpace Diagnostics to analyze a fine needle aspirate (FNA) specimen from a patient’s thyroid and receive comprehensive information about the risk of malignancy, enabling them to provide personalized care.
10. A patient with an indeterminate thyroid nodule cytopathology undergoes the ThyGeNEXT® Thyroid Oncogene Panel test by Interpace Diagnostics to assess the risk of malignancy and determine the appropriate course of action based on the test results.