How To Use CPT Code 81262

CPT 81262 describes the gene rearrangement analysis using direct probe methodology to detect abnormal clonal populations within the Immunoglobulin heavy chain locus (IGH@). 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 81262?

CPT 81262 can be used to describe the gene rearrangement analysis performed by a lab analyst using direct probe methodology. This test is used to detect the presence of specific cell populations, called clonal populations, within the Immunoglobulin heavy chain locus (IGH@). These clonal populations are indicative of lymphoid neoplasms, such as leukemias and lymphomas, specifically B-cell related ones.

2. Official Description

The official description of CPT code 81262 is: ‘IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); direct probe methodology (eg, Southern blot)’

3. Procedure

1. The lab analyst performs the technical lab test using direct probe methods to detect the presence of specific cell populations from gene rearrangements, called clonal populations, within the Immunoglobulin heavy chain locus (IGH@).
2. The lab analyst extracts nucleic acids from the cells, such as through cell lysis and digestion.
3. Restriction fragments generated by the IGH@ gene rearrangements are created.
4. The lab analyst uses direct probe methods, such as Southern blot, to identify rearrangements indicative of neoplastically transformed B cells involved in lymphoid neoplasms.

4. Qualifying circumstances

CPT 81262 is commonly ordered by clinicians to assess clonality in suspected B-cell lymphoproliferative neoplasms. It can also be ordered as a marker for certain B- and T-cell lymphoblastic leukemias. The test is not limited to testing for a specific condition, but it is used to detect abnormal clonal populations within the IGH@ gene rearrangements.

5. When to use CPT code 81262

CPT code 81262 should be used when there is a need to analyze gene rearrangements within the IGH@ gene locus using direct probe methodology. It is appropriate when there is a suspicion of lymphoid neoplasms, such as leukemias and lymphomas, specifically B-cell related ones. This code should not be used for other types of gene rearrangement analysis or for different gene loci.

6. Documentation requirements

To support a claim for CPT 81262, the documentation should include:

• Reason for ordering the test and suspected condition
• Details of the direct probe methodology used
• Specific gene rearrangements analyzed
• Results of the analysis and any abnormal clonal populations detected
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 81262, ensure that the test is performed using direct probe methodology and that it is specifically analyzing gene rearrangements within the IGH@ gene locus. It is important to distinguish CPT 81262 from other similar codes, such as CPT 81261 for gene rearrangement analysis by PCR and CPT 81263 for gene rearrangement analysis by somatic mutation analysis. It is also important to follow any additional guidelines provided by payers or specific coding guidelines for accurate billing.

8. Historical information

CPT 81262 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 gene rearrangement analysis within the IGH@ gene locus using direct probe methodology to detect abnormal clonal populations in a patient suspected of having B-cell lymphoma.
2. A clinician ordering gene rearrangement analysis within the IGH@ gene locus using direct probe methodology to assess clonality in a patient with suspected B-cell lymphoproliferative neoplasm.
3. A lab analyst analyzing gene rearrangements within the IGH@ gene locus using direct probe methodology to detect abnormal clonal populations in a patient with suspected B-cell leukemia.
4. A clinician ordering gene rearrangement analysis within the IGH@ gene locus using direct probe methodology as a marker for B-cell lymphoblastic leukemia in a patient.
5. A lab analyst performing gene rearrangement analysis within the IGH@ gene locus using direct probe methodology to detect abnormal clonal populations in a patient with suspected B-cell lymphoid neoplasm.
6. A clinician ordering gene rearrangement analysis within the IGH@ gene locus using direct probe methodology to assess clonality in a patient with suspected B-cell lymphoma.
7. A lab analyst analyzing gene rearrangements within the IGH@ gene locus using direct probe methodology to detect abnormal clonal populations in a patient with suspected B-cell leukemia.
8. A clinician ordering gene rearrangement analysis within the IGH@ gene locus using direct probe methodology as a marker for B-cell lymphoblastic leukemia in a patient.
9. A lab analyst performing gene rearrangement analysis within the IGH@ gene locus using direct probe methodology to detect abnormal clonal populations in a patient with suspected B-cell lymphoid neoplasm.
10. A clinician ordering gene rearrangement analysis within the IGH@ gene locus using direct probe methodology to assess clonality in a patient with suspected B-cell lymphoma.