How To Use CPT Code 81273

CPT 81273 describes the analysis of the D816 variant or variants of the v–kit Hardy–Zuckerman 4 feline sarcoma viral oncogene homolog, or KIT, 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 81273?

CPT 81273 can be used to describe the analysis of the D816 variant or variants of the KIT gene. This code is used when a lab analyst performs the technical steps to evaluate the presence of these variants in the v–kit Hardy–Zuckerman 4 feline sarcoma viral oncogene homolog gene. The analysis involves extracting nucleic acids, amplifying the gene, and detecting the target genes using methods such as nucleic acid probes.

2. Official Description

The official description of CPT code 81273 is: ‘KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, mastocytosis), gene analysis, D816 variant(s).’ This code specifically refers to the analysis of the D816 variant or variants of the KIT gene.

3. Procedure

1. The lab analyst performs technical steps to extract nucleic acids from the specimen.
2. The extracted nucleic acids are amplified to increase and stabilize the quantity of nucleic acid for analysis.
3. The lab analyst detects the presence of the D816 variant or variants of the KIT gene using methods such as nucleic acid probes.
4. If necessary, the lab analyst may use sensitive detection methods like pyrosequencing to test for D816 mutations that may occur in only a small number of specimen cells.

4. Qualifying circumstances

CPT 81273 is used when clinicians order the analysis of the D816 variant or variants of the KIT gene to aid in the diagnosis of diseases affected by KIT protein signaling in mast cells. This includes conditions such as systemic mastocytosis (SM) or certain leukemias involving mast cells. The analysis may also be used to guide appropriate treatment, especially in relation to tyrosine kinase inhibitor medications.

5. When to use CPT code 81273

CPT code 81273 should be used when there is a specific need to analyze the D816 variant or variants of the KIT gene. It is important to ensure that the analysis is relevant to the diagnosis or treatment of diseases affected by KIT protein signaling in mast cells. This code should not be used for general genetic analysis or for analyzing other variants of the KIT gene.

6. Documentation requirements

To support a claim for CPT 81273, documentation should include:

• Indication of the need for the analysis of the D816 variant or variants of the KIT gene
• Details of the technical steps performed by the lab analyst, including nucleic acid extraction, amplification, and detection methods
• Results of the analysis, including the presence or absence of the D816 variant or variants
• Signature of the lab analyst performing the analysis

7. Billing guidelines

When billing for CPT 81273, ensure that the analysis is specifically for the D816 variant or variants of the KIT gene. It is important to follow the guidelines provided by payers regarding the reporting of this code. Additionally, if the ordering clinician separately requests physician interpretation of the test and the pathologist renders an interpretation and writes a report, you may also report the appropriate molecular pathology procedure code for physician interpretation and report.

8. Historical information

CPT 81273 was added to the Current Procedural Terminology system on January 1, 2016. There have been no updates to the code since its addition.

9. Examples

1. A lab analyst performing the analysis of the D816 variant of the KIT gene to aid in the diagnosis of systemic mastocytosis in a patient.
2. An oncologist ordering the analysis of the D816 variant or variants of the KIT gene to guide the appropriate treatment of a patient with mast cell leukemia.
3. A hematologist requesting the analysis of the D816 variant or variants of the KIT gene to determine the prognosis of a patient with mast cell leukemia.
4. A pathologist performing the analysis of the D816 variant or variants of the KIT gene to confirm the diagnosis of systemic mastocytosis in a patient.
5. A genetic counselor ordering the analysis of the D816 variant or variants of the KIT gene to assess the risk of developing mastocytosis in a patient’s family members.
6. A molecular biologist conducting research on the prevalence of the D816 variant or variants of the KIT gene in a specific population.
7. A pharmaceutical company requesting the analysis of the D816 variant or variants of the KIT gene to evaluate the efficacy of a new tyrosine kinase inhibitor medication.
8. A clinical trial investigator using the analysis of the D816 variant or variants of the KIT gene as an inclusion criterion for a study on targeted therapies for mastocytosis.
9. A pathologist performing the analysis of the D816 variant or variants of the KIT gene to differentiate between different subtypes of mastocytosis in a patient.
10. A hematologist ordering the analysis of the D816 variant or variants of the KIT gene to monitor the response to treatment in a patient with mast cell leukemia.