How To Use CPT Code 81247

CPT 81247 describes the analysis of common variants of the glucose-6-phosphate dehydrogenase (G6PD) gene, such as A and A-. 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 81247?

CPT 81247 can be used to analyze the common variants of the G6PD gene, specifically the A and A- variants. This code is used when a lab analyst performs the technical steps to extract nucleic acids, amplify the gene, and detect the target genes using a specimen such as blood.

2. Official Description

The official description of CPT code 81247 is: ‘G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; common variant(s) (eg, A, A-).’

3. Procedure

1. The lab analyst extracts nucleic acids from the specimen, such as blood, using methods like digestion and cell lysis.
2. The lab analyst amplifies the G6PD gene, making more copies of it for analysis, using processes like polymerase chain reaction (PCR) or transcription of DNA to RNA and reverse transcription from RNA to DNA.
3. The lab analyst detects the common variants of the G6PD gene, such as A and A-, using methods like nucleic acid probes.

4. Qualifying circumstances

CPT 81247 is commonly ordered by clinicians to evaluate patients for a mutation that results in a G6PD enzyme deficiency. This deficiency can lead to drug-induced acute hemolytic anemia (AHA) when patients take certain medications like dapsone, rasburicase, and the antimalarial drug primaquine. Clinicians may also order this test to evaluate potential carrier status in females due to the X-linked trait, or to investigate unexplained jaundice in newborns.

5. When to use CPT code 81247

CPT code 81247 should be used when analyzing the common variants of the G6PD gene, such as A and A-. It is appropriate to bill this code when performing the technical lab test to identify these variants. However, it should not be used for testing specific conditions or for known familial variant testing or full gene analysis.

6. Documentation requirements

To support a claim for CPT 81247, documentation should include:

• Reason for ordering the test, such as evaluation for G6PD enzyme deficiency or unexplained jaundice
• Details of the technical steps performed, including nucleic acid extraction, gene amplification, and variant detection
• Specimen used for analysis, such as blood
• Any additional prep work performed, such as tissue selection or microdissection
• Physician interpretation and report, if separately requested

7. Billing guidelines

When billing for CPT 81247, ensure that the analysis of common variants of the G6PD gene, such as A and A-, is performed. It is important to distinguish this code from related codes for known familial variant testing or full gene analysis. Additionally, payers may separately reimburse for specimen collection using a code like 36415. If the pathologist provides a separate interpretation and report, you can report G0452 with modifier 26.

8. Historical information

CPT 81247 was added to the Current Procedural Terminology system on January 1, 2018. There have been no updates to the code since its addition.

9. Examples

1. A lab analyst performing the analysis of common variants of the G6PD gene, specifically the A and A- variants, using a blood specimen.
2. A clinician ordering CPT code 81247 to evaluate a patient for a G6PD enzyme deficiency before prescribing medications that can cause drug-induced acute hemolytic anemia.
3. A lab technician amplifying the G6PD gene and detecting the common variants, such as A and A-, to assess carrier status in a female patient.
4. A pathologist providing a separate interpretation and report for the analysis of common variants of the G6PD gene, specifically the A and A- variants.
5. A clinician ordering CPT code 81247 to investigate unexplained jaundice in a newborn and determine if a G6PD enzyme deficiency is the underlying cause.
6. A lab analyst performing the technical steps, including nucleic acid extraction, gene amplification, and variant detection, to analyze the common variants of the G6PD gene.
7. A clinician ordering CPT code 81247 to evaluate a patient with hemolytic anemia and determine if a G6PD enzyme deficiency is the underlying cause.
8. A lab technician using nucleic acid probes to detect the common variants of the G6PD gene, such as A and A-, in a blood specimen.
9. A pathologist interpreting the results of the analysis of common variants of the G6PD gene, specifically the A and A- variants, and providing a report to the ordering clinician.
10. A clinician ordering CPT code 81247 to assess a patient’s risk for drug-induced acute hemolytic anemia before prescribing medications that can trigger this condition.