How To Use CPT Code 81249

CPT 81249 describes the analysis of the full gene sequence of the glucose-6-phosphate dehydrogenase (G6PD) gene. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 81249?

CPT 81249 can be used to describe the analysis of the complete gene sequence of the G6PD gene. This code is used when a lab analyst performs the technical steps to analyze the full gene sequence, from extracting nucleic acids to detecting the target genes using a specimen such as blood.

2. Official Description

The official description of CPT code 81249 is: ‘G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; full gene sequence.’

3. Procedure

1. The lab analyst performs the technical steps to analyze the full gene sequence of the G6PD gene.
2. This includes extracting nucleic acids, amplifying the gene sequence, and detecting the target genes using methods such as nucleic acid probes.
3. A specimen, such as blood, is used for the analysis.

4. Qualifying circumstances

CPT 81249 is commonly ordered by clinicians to evaluate patients for a mutation in the G6PD gene that can result in a G6PD enzyme deficiency. This deficiency can lead to drug-induced acute hemolytic anemia (AHA) when patients take certain medications. The test may also be ordered to evaluate potential carrier status in females, as this is an X-linked trait, or to investigate unexplained jaundice in newborns.

5. When to use CPT code 81249

CPT code 81249 should be used when a lab analyst performs the analysis of the full gene sequence of the G6PD gene. It is appropriate to use this code when evaluating patients for a G6PD enzyme deficiency or investigating unexplained jaundice. This code should not be used for other types of gene analysis or variant testing.

6. Documentation requirements

To support a claim for CPT 81249, documentation should include:

• Reason for ordering the test, such as evaluation for a G6PD enzyme deficiency or investigation of unexplained jaundice
• Details of the technical steps performed by the lab analyst, including nucleic acid extraction, amplification, and detection methods
• Specimen used for the analysis

7. Billing guidelines

When billing for CPT 81249, ensure that the analysis of the full gene sequence of the G6PD gene is performed by a lab analyst. This code should not be reported with other codes for variant testing or known familial variants. Additional codes may be reported for specimen collection or interpretation of the test results, if applicable.

8. Historical information

CPT 81249 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 performs the analysis of the full gene sequence of the G6PD gene to evaluate a patient for a G6PD enzyme deficiency.
2. A clinician orders the analysis of the full gene sequence of the G6PD gene to investigate unexplained jaundice in a newborn.
3. A lab analyst analyzes the complete gene sequence of the G6PD gene to assess a patient’s potential carrier status for a G6PD enzyme deficiency.
4. A patient is prescribed a medication that can cause drug-induced acute hemolytic anemia, and the lab analyst performs the analysis of the full gene sequence of the G6PD gene to evaluate the patient’s risk.
5. A clinician orders the analysis of the full gene sequence of the G6PD gene before prescribing medications that can potentially cause drug-induced acute hemolytic anemia.
6. A lab analyst performs the analysis of the full gene sequence of the G6PD gene to confirm a suspected G6PD enzyme deficiency in a patient with hemolytic anemia.
7. A clinician orders the analysis of the full gene sequence of the G6PD gene to evaluate a patient with jaundice and determine if a G6PD enzyme deficiency is the underlying cause.
8. A lab analyst analyzes the complete gene sequence of the G6PD gene to investigate the cause of unexplained jaundice in a newborn.
9. A patient with a family history of G6PD enzyme deficiency undergoes the analysis of the full gene sequence of the G6PD gene to determine their own carrier status.
10. A clinician orders the analysis of the full gene sequence of the G6PD gene to evaluate a patient with unexplained jaundice and assess the possibility of a G6PD enzyme deficiency.