How To Use CPT Code 81110

CPT 81110 describes the genetic analysis procedure for Human Platelet Antigen 6 genotyping (HPA-6w), specifically analyzing the ITGB3 gene. 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 81110?

CPT 81110 is a code used to describe the genetic analysis procedure for Human Platelet Antigen 6 genotyping (HPA-6w). It specifically focuses on analyzing the ITGB3 gene, which is responsible for the integrin beta 3 protein found on platelets. This procedure helps assess the risk and aid in the diagnosis of conditions such as neonatal alloimmune thrombocytopenia (NAIT), post-transfusion purpura (PTP), and thrombocytopenia.

2. Official Description

The official description of CPT code 81110 is: ‘Human Platelet Antigen 6 genotyping (HPA-6w), ITGB3 (integrin, beta 3 [platelet glycoprotein IIIa, antigen CD61] [GPIIIa]) (eg, neonatal alloimmune thrombocytopenia [NAIT], post-transfusion purpura), gene analysis, common variant, HPA-6a/b (R489Q)’

3. Procedure

1. The lab analyst performs the technical lab test to analyze the genes of the two common alleles of Human Platelet Antigen 6 (HPA–6), also known as R489Q.
2. The lab analyst extracts the nucleic acids from the specimen, such as blood or amniotic fluid, using methods like digestion and cell lysis.
3. The lab analyst amplifies the nucleic acids to increase and stabilize the quantity for analysis. This is done through processes like polymerase chain reaction (PCR) or transcription of DNA to RNA and reverse transcription from RNA to make an additional copy of the DNA.
4. The lab analyst detects the target genes using methods like multiplex PCR and fluorescence or other markers to identify HPA–6 antigen alleles in the patient specimen.
5. The lab analyst identifies the patient’s HPA–6 antigen genotype, which can be homozygous (aa or bb) or heterozygous (ab).
6. The lab analyst reports the results of the genetic analysis to the ordering clinician for further assessment and diagnosis.

4. Qualifying circumstances

CPT 81110 is commonly ordered by clinicians to assess the risk or aid in the diagnosis of conditions such as neonatal alloimmune thrombocytopenia (NAIT), post-transfusion purpura (PTP), and thrombocytopenia. It helps identify the patient’s HPA–6 antigen genotype, which is crucial in understanding the potential immune response and blood-related disorders that may occur due to contact with a different HPA antigen genotype.

5. When to use CPT code 81110

CPT code 81110 should be used when there is a need to analyze the genes of the two common alleles of Human Platelet Antigen 6 (HPA–6) to assess risk or aid in the diagnosis of conditions such as neonatal alloimmune thrombocytopenia (NAIT), post-transfusion purpura (PTP), and thrombocytopenia. It is important to note that this code should not be used for testing other HPA genotypes.

6. Documentation requirements

To support a claim for CPT 81110, the documentation should include:

• Patient’s clinical indication for the test
• Specific details of the genetic analysis procedure performed
• Date of the procedure
• Results of the analysis, including the patient’s HPA–6 antigen genotype
• Signature of the lab analyst performing the procedure

7. Billing guidelines

When billing for CPT 81110, ensure that the procedure meets the requirements of the code. It is important to note that some payers may separately reimburse for specimen collection using a different code. Additionally, if the ordering clinician requests physician interpretation of the test and the pathologist provides an interpretation and report, you may report an additional code with the appropriate modifier.

8. Historical information

CPT 81110 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 81110 to assess the risk of neonatal alloimmune thrombocytopenia (NAIT) in a pregnant patient with a history of affected pregnancies.
2. A patient presents with post-transfusion purpura (PTP), and the clinician orders CPT 81110 to aid in the diagnosis of a potential transfusion reaction.
3. A clinician suspects thrombocytopenia in a patient and orders CPT 81110 to assess the patient’s HPA–6 antigen genotype.
4. A patient with a history of unexplained bleeding episodes undergoes CPT 81110 to help identify the potential cause of the bleeding.
5. A clinician orders CPT 81110 for a patient with a suspected immune response to platelet transfusions.
6. A pregnant patient with a history of neonatal alloimmune thrombocytopenia (NAIT) undergoes CPT 81110 to assess the risk of recurrence in the current pregnancy.
7. A patient with a low platelet count and a history of transfusions undergoes CPT 81110 to aid in the diagnosis of post-transfusion purpura (PTP).
8. A clinician orders CPT 81110 for a patient with a suspected genetic disorder affecting platelet function.