How To Use CPT Code 81187

CPT 81187 describes the analysis and evaluation of the CNBP gene to detect abnormal alleles, specifically expanded sequences. 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 81187?

CPT 81187 can be used to analyze and evaluate the CNBP gene to detect abnormal alleles, particularly expanded sequences. This code is utilized when the lab analyst performs the technical lab test to identify changes in the CNBP gene that may indicate the presence of abnormal alleles.

2. Official Description

The official description of CPT code 81187 is: ‘CNBP (CCHC-type zinc finger nucleic acid binding protein) (eg, myotonic dystrophy type 2) gene analysis, evaluation to detect abnormal (eg, expanded) alleles.’

3. Procedure

1. The lab analyst performs the technical lab test to detect changes in the CNBP gene.
2. The specimen, such as blood, is collected and processed to extract the nucleic acids.
3. The nucleic acids are amplified using methods like polymerase chain reaction (PCR) to increase the quantity for analysis.
4. The target genes, specifically the CNBP gene, are detected to identify abnormal alleles, particularly expanded sequences.

4. Qualifying circumstances

CPT 81187 is typically ordered by clinicians to aid in the diagnosis of myotonic dystrophy type 2 (DM2), a muscular dystrophy characterized by various symptoms. However, the test is not limited to DM2 and can be used to detect abnormal alleles involving expanded sequences in the CNBP gene for other purposes as well. The test is performed by a lab analyst using methods such as PCR to analyze the CNBP gene.

5. When to use CPT code 81187

CPT code 81187 should be used when there is a need to analyze and evaluate the CNBP gene to detect abnormal alleles, specifically expanded sequences. It is important to ensure that the test is performed by a lab analyst using appropriate methods such as PCR. This code should be used when the test is ordered for diagnostic purposes or to determine carrier status.

6. Documentation requirements

To support a claim for CPT 81187, documentation should include:

• Reason for ordering the test and the clinical indication
• Details of the specimen collected and the method used for nucleic acid extraction
• Information on the amplification method, such as PCR
• Results of the analysis, specifically the detection of abnormal alleles involving expanded sequences in the CNBP gene
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 81187, ensure that the test is performed by a lab analyst using appropriate methods. It is important to follow payer-specific guidelines and requirements for documentation and coding. If the ordering clinician requests physician interpretation of the test and the pathologist provides an interpretation and report, additional codes such as G0452 with modifier 26 may be reported. It is also important to note that CPT 81187 is distinct from other gene analysis codes, such as CPT 81234 for DMPK gene analysis.

8. Historical information

CPT 81187 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 the analysis and evaluation of the CNBP gene to detect abnormal alleles involving expanded sequences.
2. A clinician ordering CPT 81187 to aid in the diagnosis of myotonic dystrophy type 2 (DM2) by analyzing the CNBP gene.
3. A lab analyst using PCR to amplify the CNBP gene and detect abnormal alleles in a patient’s sample.
4. A patient undergoing CPT 81187 to determine carrier status for abnormal alleles in the CNBP gene.
5. A lab analyst analyzing the CNBP gene to detect expanded sequences as part of a research study.
6. A clinician ordering CPT 81187 to investigate potential genetic abnormalities in the CNBP gene for a patient with unexplained symptoms.
7. A lab analyst performing the analysis and evaluation of the CNBP gene to detect abnormal alleles in a prenatal sample.
8. A clinician ordering CPT 81187 to assess the risk of myotonic dystrophy type 2 (DM2) in a patient with a family history of the condition.
9. A lab analyst using PCR to amplify the CNBP gene and detect abnormal alleles in a patient’s sample collected during a routine check-up.
10. A patient undergoing CPT 81187 to confirm the presence of expanded sequences in the CNBP gene following a previous inconclusive test result.