How To Use CPT Code 81222

CPT 81222 describes the analysis of specific changes in the cystic fibrosis transmembrane conductance regulator (CFTR) gene, known as CFTR, involving duplication or deletion variants. 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 81222?

CPT 81222 can be used to describe the analysis of specific changes in the CFTR gene, specifically duplication or deletion variants. This code is used when a lab analyst performs the technical lab test to identify the number of copies of a specific gene sequence in the CFTR gene.

2. Official Description

The official description of CPT code 81222 is: ‘CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; duplication/deletion variants.’

3. Procedure

1. The lab analyst performs the technical lab test to analyze specific changes involving repeated or deleted nucleotides in the CFTR gene.
2. The lab analyst extracts nucleic acids from the sample, amplifies the quantity of nucleic acid for analysis, and detects the target genes using nucleic acid probes.
3. The lab analyst analyzes the CFTR gene for the number of copies of a specific gene sequence to determine if there are any duplication or deletion variants.

4. Qualifying circumstances

CPT 81222 is used for patients suspected of having cystic fibrosis when frequent CFTR mutations evaluated with other codes are not found. This test helps identify less common deletion or duplication mutations in the CFTR gene that may have been undetected by initial screening methods.

5. When to use CPT code 81222

CPT code 81222 should be used when there is a suspicion of cystic fibrosis and other CFTR mutations have been ruled out. It is important to use this code when analyzing the CFTR gene specifically for duplication or deletion variants.

6. Documentation requirements

To support a claim for CPT 81222, documentation should include:

• Reason for ordering the test and suspicion of cystic fibrosis
• Details of the technical steps performed by the lab analyst
• Results of the analysis, specifically the number of copies of the gene sequence
• Interpretation of the results by a physician, if separately requested

7. Billing guidelines

When billing for CPT 81222, ensure that the analysis is performed by a lab analyst and that the test specifically involves the analysis of duplication or deletion variants in the CFTR gene. It is important to distinguish this code from other CFTR gene analysis codes. If a physician interpretation is separately requested, it can be reported with modifier 26.

8. Historical information

CPT 81222 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 performs the analysis of the CFTR gene for a patient suspected of having cystic fibrosis, specifically looking for duplication or deletion variants.
2. A physician orders CPT 81222 for a patient who has undergone initial CFTR screening but did not show any common variants, and there is a suspicion of less common deletion or duplication mutations.
3. A lab analyst analyzes the CFTR gene for a patient with symptoms of cystic fibrosis, specifically focusing on duplication or deletion variants.
4. A physician requests CPT 81222 for a patient with a family history of cystic fibrosis and wants to rule out any duplication or deletion variants in the CFTR gene.
5. A lab analyst performs the analysis of the CFTR gene for a patient with clinical signs of cystic fibrosis, specifically looking for any duplication or deletion variants.
6. A physician orders CPT 81222 for a patient who has undergone initial CFTR screening but did not show any known familial variants, and there is a suspicion of duplication or deletion variants.
7. A lab analyst analyzes the CFTR gene for a patient with symptoms consistent with cystic fibrosis, specifically focusing on identifying any duplication or deletion variants.
8. A physician requests CPT 81222 for a patient with a family history of cystic fibrosis and wants to determine if there are any duplication or deletion variants in the CFTR gene.
9. A lab analyst performs the analysis of the CFTR gene for a patient suspected of having cystic fibrosis, specifically looking for any duplication or deletion variants.
10. A physician orders CPT 81222 for a patient who has undergone initial CFTR screening but did not show any common variants, and there is a suspicion of duplication or deletion variants in the CFTR gene.