How To Use CPT Code 81248

CPT 81248 describes the analysis of known familial variants of the glucose-6-phosphate dehydrogenase (G6PD) gene. 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 81248?

CPT 81248 can be used to analyze known familial variants of the G6PD gene. This code is used when the lab analyst performs the technical lab test to identify specific variants of the G6PD gene associated with conditions such as hemolytic anemia and jaundice.

2. Official Description

The official description of CPT code 81248 is: ‘G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; known familial variant(s).’ This code specifically refers to the analysis of known familial variants of the G6PD gene.

3. Procedure

1. The lab analyst performs the technical lab test to analyze known familial variants of the G6PD gene.
2. The lab analyst extracts nucleic acids from the specimen, such as blood, using methods like digestion and cell lysis.
3. The lab analyst amplifies the nucleic acids, increasing and stabilizing the quantity of the gene for analysis.
4. The lab analyst detects the target genes using methods like nucleic acid probes.
5. The analysis is performed using a specimen such as blood.

4. Qualifying circumstances

CPT 81248 is used when clinicians order the test to evaluate patients for a mutation in the G6PD gene that can result in an enzyme deficiency. This deficiency can lead to drug-induced acute hemolytic anemia when patients take certain medications. The test may also be ordered 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 81248

CPT code 81248 should be used when there is a clinical need to analyze known familial variants of the G6PD gene. It is appropriate to bill this code when the lab analyst performs the analysis for specific variants of the gene. However, it should not be used for common-variant testing or full gene analysis.

6. Documentation requirements

To support a claim for CPT 81248, the documentation should include:

• Reason for ordering the test, such as evaluation for G6PD enzyme deficiency
• Details of the known familial variants being analyzed
• Date and time of the analysis
• Specimen used for the analysis
• Signature of the lab analyst performing the analysis

7. Billing guidelines

When billing for CPT 81248, ensure that the analysis is performed for known familial variants of the G6PD gene. It is important to distinguish this code from related codes for common-variant testing or full gene analysis. Additional codes may be reported for specimen collection or interpretation of the test results, if applicable.

8. Historical information

CPT 81248 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 known familial variants of the G6PD gene for a patient with a family history of hemolytic anemia.
2. An analysis of known familial variants of the G6PD gene ordered by a clinician before prescribing medications that can cause drug-induced acute hemolytic anemia.
3. An evaluation of potential carrier status in females by analyzing known familial variants of the G6PD gene.
4. An analysis of known familial variants of the G6PD gene performed to investigate unexplained jaundice in a newborn.
5. A lab analyst analyzing known familial variants of the G6PD gene for a patient with a suspected G6PD enzyme deficiency.
6. An analysis of known familial variants of the G6PD gene ordered by a clinician to assess the risk of drug-induced acute hemolytic anemia in a patient.
7. A lab analyst performing the analysis of known familial variants of the G6PD gene for a patient with a family history of jaundice.
8. An analysis of known familial variants of the G6PD gene ordered by a clinician to evaluate a patient with unexplained anemia.
9. An evaluation of potential carrier status in females by analyzing known familial variants of the G6PD gene.
10. An analysis of known familial variants of the G6PD gene performed to investigate unexplained jaundice in a newborn.