How To Use CPT Code 81277

CPT 81277 describes the genetic analysis procedure known as cytogenomic neoplasia microarray analysis. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 81277?

CPT 81277 can be used to describe the genetic analysis procedure called cytogenomic neoplasia microarray analysis. This test evaluates the entire genetic makeup of a cancer patient’s tumor tissue or blood specimen to identify variations in the number of copies of gene sequences, known as copy number variants (CNV), and other chromosomal markers of abnormalities, such as loss of heterozygosity (LOH).

2. Official Description

The official description of CPT code 81277 is: ‘Cytogenomic neoplasia (genome-wide) microarray analysis, interrogation of genomic regions for copy number and loss-of-heterozygosity variants for chromosomal abnormalities. Do not report analyte-specific molecular pathology procedures separately when the specific analytes are included as part of the cytogenomic microarray analysis for neoplasia. Do not report 88271 when performing cytogenomic microarray analysis.’

3. Procedure

1. The lab analyst performs the technical lab test using a tumor tissue or blood specimen from a cancer patient.
2. The nucleic acids are extracted from the specimen using methods such as cell lysis and digestion.
3. The quantity of nucleic acid is increased and stabilized through amplification using techniques like polymerase chain reaction (PCR).
4. The specimen is labeled with fluorescent dye and hybridized with a microarray of genetic probes.
5. The patient’s genetic material is compared to a reference sample to identify copy number variants (CNV) and loss of heterozygosity (LOH).
6. The test may be performed on frozen or formalin-fixed paraffin-embedded (FFPE) tumor tissue, bone marrow, or blood from a patient with leukemia.

4. Qualifying circumstances

CPT 81277 is typically ordered for cancer patients to detect variations in solid tumor or hematologic malignancy specimens that involve clinically significant copy number variants (CNV) or loss of heterozygosity (LOH) that may impact prognosis or treatment options. The test can be performed on various types of specimens, including tumor tissue blocks or slides, bone marrow, or blood.

5. When to use CPT code 81277

CPT code 81277 should be used when performing cytogenomic neoplasia microarray analysis to evaluate the entire genome of a cancer patient for copy number variants (CNV) and loss of heterozygosity (LOH). This code should not be used for analyte-specific molecular pathology procedures or when performing other cytogenomic microarray analysis procedures.

6. Documentation requirements

To support a claim for CPT 81277, the following documentation is required:

• Details of the specimen used for the test (tumor tissue, blood, bone marrow, etc.)
• Methods used for nucleic acid extraction and amplification
• Description of the test platform and genetic probes used
• Comparison of the patient’s genetic material to a reference sample
• Identification and interpretation of copy number variants (CNV) and loss of heterozygosity (LOH)
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 81277, ensure that the test is performed for cytogenomic neoplasia microarray analysis and not for other specific analytes or procedures. Do not report CPT code 88271 when performing cytogenomic microarray analysis. If the ordering clinician separately requests physician interpretation of the test, it may be appropriate to report an additional code, such as G0452 with modifier 26, for the interpretation performed by an MD or DO physician.

8. Historical information

CPT 81277 was added to the Current Procedural Terminology system on January 1, 2020. There have been no updates to the code since its addition.

9. Examples

1. A lab analyst performs cytogenomic neoplasia microarray analysis on a tumor tissue specimen from a patient with breast cancer to identify copy number variants (CNV) and loss of heterozygosity (LOH) that may impact treatment options.
2. A geneticist evaluates the entire genome of a leukemia patient using cytogenomic neoplasia microarray analysis to detect clinically significant chromosomal abnormalities.
3. A pathologist performs cytogenomic neoplasia microarray analysis on a blood sample from a patient with lymphoma to identify genetic variations that may affect prognosis.
4. A molecular biologist uses cytogenomic neoplasia microarray analysis to evaluate a solid tumor specimen from a patient with lung cancer for copy number variants (CNV) and loss of heterozygosity (LOH) to guide personalized treatment decisions.
5. A hematologist orders cytogenomic neoplasia microarray analysis on bone marrow samples from a patient with multiple myeloma to identify chromosomal abnormalities that may impact disease progression.
6. A lab technician performs cytogenomic neoplasia microarray analysis on a frozen tumor tissue block from a patient with melanoma to detect copy number variants (CNV) and loss of heterozygosity (LOH) that may be relevant for targeted therapy.
7. A pathologist analyzes the entire genome of a patient’s tumor tissue using cytogenomic neoplasia microarray analysis to identify genetic abnormalities that may explain treatment resistance.