How To Use CPT Code 81176

CPT 81176 describes the analysis of the ASXL1 gene, specifically targeted sequence analysis of exon 12, by a lab analyst. 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 81176?

CPT 81176 can be used to describe the analysis of the ASXL1 gene, focusing on targeted sequence analysis of exon 12. This code is used when a lab analyst performs the technical steps involved in analyzing the ASXL1 gene, such as extracting nucleic acids, amplifying the gene, and detecting the target genes using a specimen like blood.

2. Official Description

The official description of CPT code 81176 is: ‘ASXL1 (additional sex combs like 1, transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; targeted sequence analysis (eg, exon 12)’

3. Procedure

1. The lab analyst performs the technical steps involved in analyzing the ASXL1 gene.
2. This includes extracting nucleic acids, amplifying the gene, and detecting the target genes using a specimen like blood.
3. The analysis focuses on targeted sequence analysis of exon 12 of the ASXL1 gene.

4. Qualifying circumstances

CPT 81176 is commonly ordered by clinicians to assist with the diagnosis and prognosis of patients with conditions such as myeloproliferative neoplasms (MPN), myelodysplastic syndromes (MDS), and chronic myelomonocytic leukemia (CMML). It is not limited to testing for a specific condition.

5. When to use CPT code 81176

CPT code 81176 should be used when a lab analyst performs targeted sequence analysis of exon 12 of the ASXL1 gene. It is important to distinguish this code from other molecular pathology tests for the ASXL1 gene, such as full gene sequence analysis (CPT code 81175).

6. Documentation requirements

To support a claim for CPT 81176, documentation should include:

• Order for the test and the reason for ordering
• Details of the technical steps performed by the lab analyst
• Specific gene sequence analyzed (exon 12 of ASXL1)
• Specimen used for analysis (e.g., blood)
• Any additional prep work performed, if applicable
• Interpretation and report, if separately requested and performed by an MD or DO physician

7. Billing guidelines

When billing for CPT 81176, ensure that the analysis is performed by a lab analyst and that the targeted sequence analysis focuses on exon 12 of the ASXL1 gene. It is important to distinguish this code from other molecular pathology tests for the ASXL1 gene. Additional tips include reporting separate codes for specimen collection (e.g., CPT code 36415) and prep work (e.g., CPT codes 88363, 88380, 88387, 88388) if applicable.

8. Historical information

CPT 81176 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 lab analyst performs targeted sequence analysis of exon 12 of the ASXL1 gene for a patient with myelodysplastic syndrome.
2. Targeted sequence analysis of exon 12 of the ASXL1 gene is performed by a lab analyst to assist with the diagnosis and prognosis of a patient with myeloproliferative neoplasms.
3. A clinician orders targeted sequence analysis of exon 12 of the ASXL1 gene for a patient with chronic myelomonocytic leukemia.
4. A lab analyst analyzes the ASXL1 gene, specifically exon 12, to provide insights into the condition of a patient with myelodysplastic syndrome.
5. Targeted sequence analysis of exon 12 of the ASXL1 gene is performed by a lab analyst to aid in the diagnosis and management of a patient with myeloproliferative neoplasms.
6. A clinician requests targeted sequence analysis of exon 12 of the ASXL1 gene to assist in the prognosis of a patient with chronic myelomonocytic leukemia.
7. A lab analyst performs targeted sequence analysis of exon 12 of the ASXL1 gene for a patient with myelodysplastic syndrome, providing valuable information for their treatment plan.
8. Targeted sequence analysis of exon 12 of the ASXL1 gene is conducted by a lab analyst to support the diagnosis and prognosis of a patient with myeloproliferative neoplasms.
9. A clinician orders targeted sequence analysis of exon 12 of the ASXL1 gene for a patient with chronic myelomonocytic leukemia, aiding in their personalized care.
10. A lab analyst analyzes the ASXL1 gene, specifically exon 12, to provide crucial insights into the condition of a patient with myelodysplastic syndrome.