How To Use CPT Code 81111

CPT 81111 describes the genetic analysis procedure for Human Platelet Antigen 9 genotyping (HPA-9w), specifically analyzing the ITGA2B gene variant (integrin, alpha 2b [platelet glycoprotein IIb of IIb/IIIa complex, antigen CD41] [GPIIb]) known as V837M. 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 81111?

CPT 81111 is used to perform a genetic analysis procedure to determine the presence of the two common alleles of Human Platelet Antigen 9 (HPA-9), specifically the ITGA2B gene variant known as V837M. This test involves analyzing the patient’s genes using a specimen such as blood or amniotic fluid.

2. Official Description

The official description of CPT code 81111 is: ‘Human Platelet Antigen 9 genotyping (HPA-9w), ITGA2B (integrin, alpha 2b [platelet glycoprotein IIb of IIb/IIIa complex, antigen CD41] [GPIIb]) (eg, neonatal alloimmune thrombocytopenia [NAIT], post-transfusion purpura), gene analysis, common variant, HPA-9a/b (V837M)’

3. Procedure

1. The lab analyst performs the technical steps of the genetic analysis procedure for HPA-9 genotyping.
2. The lab analyst extracts the nucleic acids from the patient’s specimen, such as blood or amniotic fluid.
3. The lab analyst amplifies the nucleic acids to increase the quantity for analysis.
4. The lab analyst uses methods such as polymerase chain reaction (PCR) to detect the target genes, specifically the ITGA2B gene variant V837M.
5. The lab analyst identifies the HPA-9 antigen alleles in the patient’s specimen using fluorescence or other markers.

4. Qualifying circumstances

CPT 81111 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 is used to identify the patient’s HPA-9 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.

5. When to use CPT code 81111

CPT code 81111 should be used when a genetic analysis procedure is performed to determine the presence of the ITGA2B gene variant V837M, specifically for HPA-9 genotyping. It is appropriate to use this code when assessing risk or aiding in the diagnosis of conditions related to HPA-9 genotyping.

6. Documentation requirements

To support a claim for CPT 81111, the documentation should include:

• Reason for ordering the test, such as suspected NAIT, PTP, or thrombocytopenia
• Details of the genetic analysis procedure performed, including the use of PCR and fluorescence markers
• Identification of the patient’s HPA-9 antigen genotype, specifically the ITGA2B gene variant V837M
• Signature of the lab analyst performing the procedure

7. Billing guidelines

When billing for CPT 81111, ensure that the genetic analysis procedure for HPA-9 genotyping is performed. It is important to follow the specific guidelines provided by the payer regarding documentation and coding requirements. Additionally, consider reporting any separate specimen collection using the appropriate code, such as 36415. It is crucial to distinguish CPT 81111 from other HPA genotype tests described by different codes in the range 81105-81112.

8. Historical information

CPT 81111 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 81111 to assess the risk of neonatal alloimmune thrombocytopenia (NAIT) in a pregnant patient.
2. A patient with a history of post-transfusion purpura (PTP) undergoes CPT 81111 to aid in the diagnosis of a potential transfusion reaction.
3. A clinician orders CPT 81111 to determine the HPA-9 antigen genotype of a fetus with suspected NAIT.
4. A patient with thrombocytopenia undergoes CPT 81111 to assess the underlying cause of the condition.
5. A clinician orders CPT 81111 to assess the risk of NAIT in prospective parents who have had an affected pregnancy.
6. A patient exhibits symptoms of PTP, and CPT 81111 is performed to aid in the diagnosis of a potential transfusion reaction.
7. A clinician orders CPT 81111 to determine the HPA-9 antigen genotype of a neonate with suspected NAIT.
8. A patient with unexplained thrombocytopenia undergoes CPT 81111 to identify any genetic factors contributing to the condition.
9. A clinician orders CPT 81111 to assess the risk of NAIT in a patient planning to undergo a blood transfusion.
10. A patient with a family history of NAIT undergoes CPT 81111 to determine their HPA-9 antigen genotype.