How To Use CPT Code 0329U

CPT 0329U describes the analysis of oncology (neoplasia) using exome and transcriptome sequencing. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 0329U?

CPT 0329U can be used to describe the analysis of oncology (neoplasia) using exome and transcriptome sequencing. This code is specifically used for the evaluation of sequence variants, gene copy number amplifications and deletions, gene rearrangements, microsatellite instability, and tumor mutational burden. The analysis is performed on DNA and RNA from tumor tissue, along with DNA from normal blood or saliva for subtraction. The report generated includes clinically significant mutations and their associations with therapy.

2. Official Description

The official description of CPT code 0329U is: ‘Oncology (neoplasia), exome and transcriptome sequence analysis for sequence variants, gene copy number amplifications and deletions, gene rearrangements, microsatellite instability and tumor mutational burden utilizing DNA and RNA from tumor with DNA from normal blood or saliva for subtraction, report of clinically significant mutation(s) with therapy associations.’

3. Procedure

1. The laboratory analyst processes tumor tissue and a normal specimen (blood or saliva) from the patient.
2. Next-generation sequencing (NGS) is used to sequence all protein-producing genes (exome) and a targeted group of other DNA regions relevant to cancer.
3. The analysis includes evaluation of copy number variants (CNVs), gene rearrangements, microsatellite instability, and tumor mutational burden.
4. RNA (transcriptome) is also evaluated for changes relevant to cancer.
5. The resulting report focuses on clinically significant genetic changes that occur in the tumor but not the normal specimen, along with a list of therapies associated with the findings.

4. Qualifying circumstances

CPT 0329U is used for patients with oncology (neoplasia) conditions. It is typically employed in cases of rare, aggressive, or difficult-to-treat cancers where identifying specific mutations in cancer genes can help guide treatment decisions. The analysis requires DNA and RNA samples from tumor tissue, as well as DNA from normal blood or saliva for comparison. The test evaluates sequence variants, gene copy number amplifications and deletions, gene rearrangements, microsatellite instability, and tumor mutational burden.

5. When to use CPT code 0329U

CPT code 0329U should be used when there is a need to analyze oncology (neoplasia) using exome and transcriptome sequencing. It is appropriate for cases where identifying clinically significant mutations and their associations with therapy can aid in treatment decisions. This code should not be used for other types of sequencing or analysis.

6. Documentation requirements

To support a claim for CPT code 0329U, the laboratory must document the following information:

• Patient’s diagnosis and indication for the analysis
• Details of the specimens used (tumor tissue, normal blood or saliva)
• Date of the analysis
• Specific genetic changes identified in the tumor
• List of therapies associated with the identified genetic changes

7. Billing guidelines

When billing for CPT code 0329U, ensure that the analysis is performed using the specific test Oncomap™ ExTra from Genomic Health Inc., a wholly owned subsidiary of Exact Sciences Inc. Report one unit of this code for a single specimen analyzed on a single date of service. Some payers may also provide separate reimbursement for specimen collection. It is important to use this code only for the described test and not report it using any other CPT code.

8. Historical information

CPT code 0329U was added to the Current Procedural Terminology system on July 1, 2022. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient with a rare form of cancer undergoes exome and transcriptome sequencing using CPT code 0329U. The analysis identifies a clinically significant mutation associated with a targeted therapy, guiding the treatment plan.
2. In a case of aggressive breast cancer, CPT code 0329U is used to analyze the tumor tissue and identify specific genetic changes. The report provides information on therapies that have shown efficacy in similar cases, aiding in treatment decision-making.
3. A patient with a difficult-to-treat lung cancer undergoes exome and transcriptome sequencing using CPT code 0329U. The analysis reveals a gene rearrangement that is associated with a targeted therapy, leading to a personalized treatment approach.
4. In a case of a rare pediatric tumor, CPT code 0329U is employed to analyze the tumor tissue and identify any clinically significant mutations. The report provides insights into potential therapeutic options, helping the healthcare team make informed treatment decisions.
5. A patient with advanced melanoma undergoes exome and transcriptome sequencing using CPT code 0329U. The analysis reveals a high tumor mutational burden, indicating a potential response to immunotherapy.
6. In a case of a rare gastrointestinal cancer, CPT code 0329U is used to analyze the tumor tissue and identify any gene copy number amplifications or deletions. The report provides information on targeted therapies that may be effective in treating the specific genetic changes identified.
7. A patient with a challenging-to-treat brain tumor undergoes exome and transcriptome sequencing using CPT code 0329U. The analysis reveals a specific sequence variant that is associated with a clinical trial for a novel therapy, offering the patient a potential treatment option.
8. In a case of a rare sarcoma, CPT code 0329U is employed to analyze the tumor tissue and identify any microsatellite instability. The report provides information on therapies that have shown efficacy in tumors with similar genetic changes, guiding the treatment plan.
9. A patient with a difficult-to-diagnose cancer undergoes exome and transcriptome sequencing using CPT code 0329U. The analysis reveals a gene rearrangement that is associated with a targeted therapy, providing a potential treatment option for the patient.
10. In a case of a rare hematological malignancy, CPT code 0329U is used to analyze the tumor tissue and identify any clinically significant mutations. The report provides insights into potential therapeutic options, helping the healthcare team make informed treatment decisions.