How To Use CPT Code 81184

CPT 81184 describes the genetic analysis procedure for the CACNA1A gene, specifically evaluating and detecting abnormal alleles. 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 81184?

CPT 81184 can be used to describe the genetic analysis procedure for the CACNA1A gene. This code is specifically used to evaluate and detect abnormal alleles, particularly those involving expanded sequences. The test is performed to characterize changes in the calcium voltage-gated channel subunit alpha1 A gene, which is associated with various conditions such as spinocerebellar ataxia.

2. Official Description

The official description of CPT code 81184 is: ‘CACNA1A (calcium voltage-gated channel subunit alpha1 A) (eg, spinocerebellar ataxia) gene analysis; evaluation to detect abnormal (eg, expanded) alleles.’

3. Procedure

1. The lab analyst performs the technical lab test to analyze the CACNA1A gene and detect abnormal alleles.
2. The procedure involves extracting nucleic acids from a specimen, such as blood, using methods like cell lysis and digestion.
3. The lab analyst then amplifies and stabilizes the quantity of nucleic acid for analysis using techniques like polymerase chain reaction (PCR).
4. The target genes, specifically the CACNA1A gene, are detected and characterized during the analysis.

4. Qualifying circumstances

CPT 81184 is used when there is a need to evaluate and detect abnormal alleles in the CACNA1A gene. This test is commonly ordered to aid in the diagnosis of spinocerebellar ataxia 6 (SCA6), a heritable disease characterized by poor coordination. It may also be performed to determine carrier status for certain conditions. The test is typically performed by a lab analyst using a specimen such as blood.

5. When to use CPT code 81184

CPT code 81184 should be used when there is a clinical need to evaluate and detect abnormal alleles in the CACNA1A gene. It is commonly ordered to aid in the diagnosis of spinocerebellar ataxia 6 (SCA6) or to determine carrier status. This code should be used specifically for the genetic analysis procedure of the CACNA1A gene.

6. Documentation requirements

To support a claim for CPT 81184, documentation should include:

• Reason for ordering the test and the clinical need for evaluating the CACNA1A gene
• Details of the specimen used for the analysis
• Specific techniques and methods employed during the analysis, such as cell lysis, digestion, and PCR
• Results of the analysis, including the detection and characterization of abnormal alleles
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 81184, ensure that the test is performed by a lab analyst and that the documentation supports the need for evaluating the CACNA1A gene. It is important to distinguish between the different CPT-listed tests for the CACNA1A gene, such as full gene sequence analysis (CPT 81185) and known familial variants (CPT 81186). Additionally, consider reporting separate codes for specimen collection, if applicable.

8. Historical information

CPT 81184 was added to the Current Procedural Terminology system on January 1, 2019. There have been no updates to the code since its addition.

9. Examples

1. A lab analyst performing genetic analysis of the CACNA1A gene to detect abnormal alleles in a patient with suspected spinocerebellar ataxia.
2. An individual undergoing genetic testing to determine carrier status for the CACNA1A gene.
3. A lab analyst analyzing the CACNA1A gene to detect and characterize expanded alleles in a research study.
4. A patient with a family history of spinocerebellar ataxia undergoing genetic analysis of the CACNA1A gene to assess their risk.
5. A lab analyst performing genetic analysis of the CACNA1A gene to aid in the diagnosis of a patient with unexplained coordination difficulties.
6. A research study investigating the prevalence of abnormal alleles in the CACNA1A gene among a specific population.
7. A lab analyst analyzing the CACNA1A gene to detect and characterize expanded alleles in a patient with atypical symptoms of spinocerebellar ataxia.
8. An individual undergoing genetic testing for the CACNA1A gene as part of a preconception screening.
9. A lab analyst performing genetic analysis of the CACNA1A gene to confirm a suspected diagnosis of spinocerebellar ataxia.
10. A patient with a family history of spinocerebellar ataxia undergoing genetic analysis of the CACNA1A gene to assess their risk and inform family planning decisions.