How To Use CPT Code 81193

CPT 81193 describes the analysis of NTRK3 (neurotrophic receptor tyrosine kinase 3) translocations in solid tumors. 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 81193?

CPT 81193 can be used to analyze NTRK3 translocations in solid tumors. This code is used when a lab analyst performs technical lab tests using a specimen, such as formalin-fixed paraffin-embedded tissue (FFPE), to detect gene rearrangements involved with specific breakpoints and translocations in the NTRK3 gene. The analysis is done using methods such as RNA-based next-generation sequencing (NGS) to identify candidates for specific tropomyosin receptor kinase (TRK) inhibitor therapy.

2. Official Description

The official description of CPT code 81193 is: ‘NTRK3 (neurotrophic receptor tyrosine kinase 3) (eg, solid tumors) translocation analysis.’

3. Procedure

1. The lab analyst performs technical steps, starting from extracting nucleic acids from the specimen, such as FFPE tissue, to amplifying the quantity of nucleic acid for analysis using methods like polymerase chain reaction (PCR).
2. The lab analyst detects gene rearrangements involved with specific breakpoints and translocations in the NTRK3 gene using methods such as RNA-based next-generation sequencing (NGS).

4. Qualifying circumstances

CPT 81193 is used for the analysis of NTRK3 translocations in solid tumors. This test may be ordered by clinicians for a wide array of solid tumors to identify candidates for specific TRK inhibitor therapy. NTRK gene fusions are involved in cell proliferation in many types of solid tumors, leading to tumor growth. For example, the ETV6/NTRK3 (t(12;15)) translocation is implicated in congenital/infantile fibrosarcoma.

5. When to use CPT code 81193

CPT code 81193 should be used when analyzing NTRK3 translocations in solid tumors using methods such as RNA-based NGS. It is appropriate to bill this code when the analysis is performed to identify candidates for specific TRK inhibitor therapy. This code should not be used for other methods of NTRK translocation analysis, such as immunohistochemistry staining or DNA fluorescence in situ hybridization (FISH).

6. Documentation requirements

To support a claim for CPT 81193, documentation should include:

• Order for the test and the clinical indication
• Details of the specimen used, such as FFPE tissue
• Methods used for nucleic acid extraction and amplification
• Details of the gene rearrangements and translocations detected
• Interpretation of the test results, if separately requested
• Signature of the interpreting physician, if applicable

7. Billing guidelines

When billing for CPT 81193, ensure that the analysis is performed by a lab analyst using appropriate methods, such as RNA-based NGS. It is important to distinguish this code from other codes for NTRK translocation analysis, such as CPT 81191, 81192, and 81194. Additional codes may be reported for specimen collection or processing, if separately performed. If the interpreting physician provides a separate interpretation, an additional code, such as G0452 with modifier 26, may be reported.

8. Historical information

CPT 81193 was added to the Current Procedural Terminology system on January 1, 2021. There have been no updates to the code since its addition.

9. Examples

1. A lab analyst performs NTRK3 translocation analysis on formalin-fixed paraffin-embedded tissue from a patient with congenital/infantile fibrosarcoma.
2. NTRK3 translocation analysis is performed on solid tumor tissue to identify candidates for specific TRK inhibitor therapy.
3. A specimen of solid tumor tissue is analyzed for NTRK3 translocations using RNA-based next-generation sequencing.
4. The lab performs NTRK3 translocation analysis on tissue from a patient with a suspected NTRK gene fusion.
5. NTRK3 translocation analysis is performed on solid tumor tissue to determine the presence of specific gene rearrangements.
6. A lab analyst analyzes NTRK3 translocations in solid tumors using formalin-fixed paraffin-embedded tissue specimens.
7. NTRK3 translocation analysis is performed on tissue from a patient with a solid tumor to guide treatment decisions.
8. A specimen of solid tumor tissue is analyzed for NTRK3 translocations using RNA-based next-generation sequencing to identify potential candidates for TRK inhibitor therapy.
9. The lab performs NTRK3 translocation analysis on tissue from a patient with a solid tumor to assess the presence of specific gene rearrangements.
10. NTRK3 translocation analysis is performed on solid tumor tissue to determine the suitability of TRK inhibitor therapy for the patient.