How To Use CPT Code 0331U

CPT 0331U describes a proprietary laboratory analysis (PLA) code for optical genome mapping (OGM) used to identify copy number alterations and gene rearrangements in hematolymphoid neoplasia. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of CPT code 0331U.

1. What is CPT Code 0331U?

CPT 0331U is a PLA code that represents a specific laboratory test performed by Augusta Hematology Optical Genome Mapping from Georgia Esoteric and Molecular (GEM) Laboratory LLC. This test utilizes optical genome mapping (OGM) to identify clinically significant copy number alterations (CNVs) and gene rearrangements associated with hematolymphoid neoplasia, which includes blood and bone marrow cancers.

2. Official Description

The official description of CPT code 0331U is a laboratory test for oncology (hematolymphoid neoplasia) that utilizes optical genome mapping (OGM) to identify copy number alterations (CNVs) and gene rearrangements using DNA from blood or bone marrow. The code specifically applies to the Augusta Hematology Optical Genome Mapping test provided by Georgia Esoteric and Molecular (GEM) Laboratory LLC. The report should include clinically significant alterations.

3. Procedure

1. The laboratory analyst performs optical genome mapping (OGM) using the Saphyr® System from Bionano Genomics Inc.
2. The Saphyr® System allows for the optical evaluation of chromosomes, detecting large-scale changes in DNA, such as structural variants (SVs) and copy number variants (CNVs).
3. The test provides findings similar to a combination of cytogenetic techniques, including karyotyping, chromosomal microarrays (CMAs), and fluorescence in situ hybridization (FISH).
4. OGM identifies relevant chromosomal aberrations that impact the diagnosis and treatment of hematologic neoplasms, such as chronic lymphocytic leukemia (CLL), acute myeloid leukemia (AML), myelodysplastic syndromes (MDS), multiple myeloma (MM), plasma cell myeloma (PCM), chronic myeloid leukemia (CML), and more.

4. Qualifying circumstances

CPT code 0331U is used for patients with hematolymphoid neoplasia, which includes various blood and bone marrow cancers. Clinicians may order this test to detect all relevant chromosomal aberrations that impact the diagnosis and treatment of these conditions. The test is performed using DNA from blood or bone marrow samples, and the results should include a report of clinically significant alterations.

5. When to use CPT code 0331U

CPT code 0331U should be used specifically for the Augusta Hematology Optical Genome Mapping test provided by Georgia Esoteric and Molecular (GEM) Laboratory LLC. It should not be reported using any other CPT code. This code is appropriate when there is a need to identify copy number alterations (CNVs) and gene rearrangements in hematolymphoid neoplasia using DNA from blood or bone marrow.

6. Documentation requirements

To support a claim for CPT code 0331U, the following documentation is required:

• Indication of the patient’s hematolymphoid neoplasia diagnosis
• Details of the optical genome mapping (OGM) procedure performed
• Date of service and specific DNA source (blood or bone marrow)
• Report of clinically significant copy number alterations (CNVs) and gene rearrangements
• Signature of the laboratory analyst performing the test

7. Billing guidelines

When billing for CPT code 0331U, ensure that the test is performed by Augusta Hematology Optical Genome Mapping from Georgia Esoteric and Molecular (GEM) Laboratory LLC. This PLA code takes precedence over other laboratory/pathology codes for the specific test it represents. It should not be reported using any other CPT code. It is important to follow payer-specific guidelines and consider reporting requirements for specimen collection, if applicable.

8. Historical information

CPT code 0331U was added to the Current Procedural Terminology system on July 1, 2022. As a relatively new code, there have been no updates or changes since its addition.

9. Examples

Here are some examples of scenarios where CPT code 0331U may be used:

1. A patient with chronic lymphocytic leukemia (CLL) undergoes the Augusta Hematology Optical Genome Mapping test to identify clinically significant copy number alterations and gene rearrangements.
2. A diagnosis of acute myeloid leukemia (AML) prompts the ordering of the optical genome mapping (OGM) test to detect relevant chromosomal aberrations.
3. A patient with multiple myeloma (MM) undergoes the Augusta Hematology Optical Genome Mapping test to identify copy number alterations and gene rearrangements that impact their diagnosis and treatment.
4. A suspected case of myelodysplastic syndromes (MDS) leads to the ordering of the optical genome mapping (OGM) test to detect clinically significant alterations in the patient’s DNA.
5. A plasma cell myeloma (PCM) patient undergoes the Augusta Hematology Optical Genome Mapping test to identify copy number alterations and gene rearrangements that may impact their treatment plan.