How To Use CPT Code 81263

CPT 81263 describes the analysis of mutations in the VH or variable region of the Immunoglobulin heavy chain locus, also known as 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 81263?

CPT 81263 can be used to analyze mutations in the VH or variable region of the Immunoglobulin heavy chain locus, specifically for diseases like leukemia and lymphoma, B-cell. This code is used when a lab analyst performs the technical steps involved in extracting nucleic acids, reverse transcription, amplification, gel electrophoresis, fluorescence detection, and comparing the results to a gene sequence database to determine the percentage of mutation in the VH region.

2. Official Description

The official description of CPT code 81263 is: ‘IGH@ (Immunoglobulin heavy chain locus) (eg, leukemia and lymphoma, B-cell), variable region somatic mutation analysis.’

3. Procedure

1. The lab analyst extracts nucleic acids from the patient’s sample using methods such as cell lysis and digestion.
2. Reverse transcription is performed to generate a complementary DNA sequence from the template of RNA.
3. The lab analyst amplifies the DNA sequence and analyzes the direct DNA sequence using gel electrophoresis and fluorescence detection.
4. The results are compared to a gene sequence database to determine the percentage of mutation in the VH region.

4. Qualifying circumstances

CPT 81263 is commonly ordered by clinicians for patients diagnosed with B-cell chronic lymphocytic leukemia (B-CLL) to characterize the disease as indolent or aggressive based on mutation status, which aids in disease prognosis. However, this test is not limited to a specific condition and can be used for other diseases involving the IGH@ gene.

5. When to use CPT code 81263

CPT code 81263 should be used when there is a need to analyze mutations in the VH or variable region of the Immunoglobulin heavy chain locus, specifically for diseases like leukemia and lymphoma, B-cell. It is important to distinguish this code from other codes that involve different methods of analyzing IGH@ gene rearrangement.

6. Documentation requirements

To support a claim for CPT 81263, documentation should include:

• Patient’s diagnosis and indication for the test
• Details of the technical steps performed, including nucleic acid extraction, reverse transcription, amplification, gel electrophoresis, fluorescence detection, and comparison to a gene sequence database
• Results of the analysis, specifically the percentage of mutation in the VH region
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 81263, ensure that the test is performed by a qualified lab analyst. It is important to distinguish this code from other codes that involve different methods of analyzing IGH@ gene rearrangement. There are no specific guidelines regarding reporting CPT 81263 with other codes.

8. Historical information

CPT 81263 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 technical steps involved in analyzing mutations in the VH region of the Immunoglobulin heavy chain locus for a patient diagnosed with B-cell chronic lymphocytic leukemia.
2. The VH region somatic mutation analysis is conducted by a lab analyst to determine the percentage of mutation in the Immunoglobulin heavy chain locus for a patient with B-cell lymphoma.
3. A clinician orders the analysis of VH region mutations in the Immunoglobulin heavy chain locus for a patient with suspected B-cell leukemia to aid in disease prognosis.
4. A lab analyst performs the VH region somatic mutation analysis for a patient with a B-cell disorder to assess the aggressiveness of the disease based on mutation status.
5. The analysis of VH region mutations in the Immunoglobulin heavy chain locus is conducted by a lab analyst for a patient with a B-cell malignancy to guide treatment decisions.
6. A clinician orders the VH region somatic mutation analysis for a patient with B-cell lymphoma to determine the percentage of mutation in the Immunoglobulin heavy chain locus.
7. A lab analyst performs the analysis of VH region mutations in the Immunoglobulin heavy chain locus for a patient with B-cell leukemia to assess the disease progression.
8. The VH region somatic mutation analysis is conducted by a lab analyst for a patient with B-cell lymphoproliferative disorder to characterize the disease based on mutation status.
9. A clinician orders the analysis of VH region mutations in the Immunoglobulin heavy chain locus for a patient with B-cell malignancy to evaluate the response to treatment.
10. A lab analyst performs the VH region somatic mutation analysis for a patient with B-cell lymphocytic lymphoma to determine the percentage of mutation in the Immunoglobulin heavy chain locus.