How To Use CPT Code 81207

CPT 81207 describes the analysis of the BCR/ABL1 (t(9;22)) translocation, specifically focusing on the minor breakpoint gene sequence. 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 81207?

CPT 81207 can be used to describe the analysis of the BCR/ABL1 (t(9;22)) translocation, specifically focusing on the minor breakpoint gene sequence. This code is used when a lab analyst performs a technical lab test to evaluate the presence or quantity of the BCR/ABL1 fusion gene associated with the minor breakpoint.

2. Official Description

The official description of CPT code 81207 is: ‘BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; minor breakpoint, qualitative or quantitative.’

3. Procedure

1. The lab analyst performs the technical lab test to evaluate the minor breakpoint gene sequence BCR/ABL1 that occurs on chromosome 22 due to translocation.
2. The test can be qualitative, identifying the presence of the BCR/ABL1 fusion gene associated with the minor breakpoint, or quantitative, measuring the amount of each fusion gene present.
3. The lab analyst performs all technical steps, including extracting nucleic acids, amplifying and stabilizing the quantity of nucleic acid for analysis, detecting the target DNA sequence, and measuring the relative quantity of the target gene sequences.

4. Qualifying circumstances

CPT 81207 is used when there is a need to analyze the BCR/ABL1 (t(9;22)) translocation, specifically focusing on the minor breakpoint gene sequence. This analysis is commonly ordered to help diagnose acute lymphoblastic leukemia (ALL) in children known to have the Philadelphia chromosome, where the minor breakpoint BCR/ABL1 gene rearrangement is associated with ALL.

5. When to use CPT code 81207

CPT code 81207 should be used when there is a need to analyze the BCR/ABL1 (t(9;22)) translocation, specifically focusing on the minor breakpoint gene sequence. It is important to note that this code should not be used for testing related to other gene sequences or translocations.

6. Documentation requirements

To support a claim for CPT 81207, documentation should include:

• Indication of the need for BCR/ABL1 (t(9;22)) translocation analysis
• Whether the analysis performed was qualitative or quantitative
• Results of the analysis, including the presence or quantity of the BCR/ABL1 fusion gene associated with the minor breakpoint
• Signature of the lab analyst performing the analysis

7. Billing guidelines

When billing for CPT 81207, ensure that the analysis is performed by a lab analyst and that the documentation supports the need for BCR/ABL1 (t(9;22)) translocation analysis. It is important to note that CPT code 81207 should not be reported with other codes unless specifically requested by the ordering clinician for physician interpretation.

8. Historical information

CPT 81207 was added to the Current Procedural Terminology system on January 1, 2012. There have been no updates to the code since its addition.

9. Examples

1. A lab analyst performing a qualitative analysis of the BCR/ABL1 (t(9;22)) translocation, specifically focusing on the minor breakpoint gene sequence, to identify the presence of the BCR/ABL1 fusion gene associated with chronic myelogenous leukemia.
2. A lab analyst performing a quantitative analysis of the BCR/ABL1 (t(9;22)) translocation, specifically focusing on the minor breakpoint gene sequence, to measure the amount of the BCR/ABL1 fusion gene present in a patient with chronic myelogenous leukemia.
3. A lab analyst performing a qualitative analysis of the BCR/ABL1 (t(9;22)) translocation, specifically focusing on the minor breakpoint gene sequence, to identify the presence of the BCR/ABL1 fusion gene associated with acute lymphoblastic leukemia in a child known to have the Philadelphia chromosome.
4. A lab analyst performing a quantitative analysis of the BCR/ABL1 (t(9;22)) translocation, specifically focusing on the minor breakpoint gene sequence, to measure the amount of the BCR/ABL1 fusion gene present in a child known to have the Philadelphia chromosome and diagnosed with acute lymphoblastic leukemia.
5. A lab analyst performing a qualitative analysis of the BCR/ABL1 (t(9;22)) translocation, specifically focusing on the minor breakpoint gene sequence, to identify the presence of the BCR/ABL1 fusion gene associated with chronic myelogenous leukemia in a patient undergoing treatment.
6. A lab analyst performing a quantitative analysis of the BCR/ABL1 (t(9;22)) translocation, specifically focusing on the minor breakpoint gene sequence, to measure the amount of the BCR/ABL1 fusion gene present in a patient with chronic myelogenous leukemia undergoing targeted therapy.