How To Use CPT Code 81105

CPT 81105 describes the genetic analysis procedure for Human Platelet Antigen 1 (HPA-1) genotyping. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 81105?

CPT 81105 is a code used to describe the genetic analysis procedure for Human Platelet Antigen 1 (HPA-1) genotyping. This test analyzes the genes of the two common alleles of HPA-1, also known as CD61 or ITGB3, to assess the risk or aid in the diagnosis of conditions such as neonatal alloimmune thrombocytopenia (NAIT) and post-transfusion purpura (PTP). The test determines the patient’s HPA-1 antigen genotype, which helps identify potential transfusion reactions or assess pregnancy risk in affected pregnancies.

2. Official Description

The official description of CPT code 81105 is: ‘Human Platelet Antigen 1 genotyping (HPA-1), ITGB3 (integrin, beta 3 [platelet glycoprotein IIIa], antigen CD61 [GPIIIa]) (eg, neonatal alloimmune thrombocytopenia [NAIT], post-transfusion purpura), gene analysis, common variant, HPA-1a/b (L33P)’

3. Procedure

1. The lab analyst performs the technical lab test to analyze the genes of the two common alleles of Human Platelet Antigen 1 (HPA–1), also called CD61 or ITGB3, using a specimen such as blood or amniotic fluid.
2. The lab analyst performs all technical steps, including nucleic acid extraction, amplification, and detection of the target genes using methods such as polymerase chain reaction (PCR) and fluorescence markers.
3. The test specifically identifies the HPA–1 antigen alleles in the patient specimen, such as blood or amniotic fluid, to determine the patient’s HPA–1 antigen genotype.

4. Qualifying circumstances

CPT 81105 is commonly ordered by clinicians to assess the risk or aid in the diagnosis of conditions such as neonatal alloimmune thrombocytopenia (NAIT) and post-transfusion purpura (PTP). It is used to identify patient HPA–1 antigen genotype for fetuses or neonates with suspected NAIT, assess pregnancy risk for parents or prospective parents who have had an affected pregnancy, or aid in the diagnosis of potential transfusion reactions in patients exhibiting PTP and thrombocytopenia.

5. When to use CPT code 81105

CPT code 81105 should be used when there is a clinical need to assess the risk or aid in the diagnosis of conditions related to HPA–1 antigen genotype. It is appropriate to use this code when performing genetic analysis for HPA–1a/b (L33P) common variant.

6. Documentation requirements

To support a claim for CPT 81105, the documentation should include:

• Reason for ordering the test and the clinical need
• Details of the technical steps performed by the lab analyst
• Specific methods used for nucleic acid extraction, amplification, and detection
• Identification of the HPA–1 antigen alleles in the patient specimen
• Interpretation of the test results
• Signature of the interpreting physician, if applicable

7. Billing guidelines

When billing for CPT 81105, ensure that the test is performed for the analysis of HPA–1 antigen genotype. It is important to follow the specific guidelines provided by payers regarding documentation and coding requirements. Additionally, consider reporting separate codes for collecting the specimen, if applicable.

8. Historical information

CPT 81105 was added to the Current Procedural Terminology system on January 1, 2018. There have been no updates to the code since its addition.

9. Examples

1. A clinician orders CPT 81105 to assess the risk of neonatal alloimmune thrombocytopenia (NAIT) in a pregnant patient with a history of affected pregnancies.
2. A patient with a suspected transfusion reaction undergoes CPT 81105 to aid in the diagnosis of post-transfusion purpura (PTP) and thrombocytopenia.
3. A clinician orders CPT 81105 to determine the HPA–1 antigen genotype of a fetus with suspected neonatal alloimmune thrombocytopenia (NAIT).
4. A patient with a history of affected pregnancies undergoes CPT 81105 to assess the risk of neonatal alloimmune thrombocytopenia (NAIT) in future pregnancies.
5. CPT 81105 is performed on a patient with thrombocytopenia to aid in the diagnosis of post-transfusion purpura (PTP).
6. A clinician orders CPT 81105 to determine the HPA–1 antigen genotype of a patient exhibiting thrombocytopenia and suspected post-transfusion purpura (PTP).
7. A pregnant patient with a history of affected pregnancies undergoes CPT 81105 to assess the risk of neonatal alloimmune thrombocytopenia (NAIT) in the current pregnancy.
8. CPT 81105 is performed on a patient with a suspected transfusion reaction to aid in the diagnosis of post-transfusion purpura (PTP) and thrombocytopenia.