How To Use CPT Code 81283

CPT 81283 describes the genetic analysis procedure for detecting changes in the interferon, lambda 3 (IFNL3) gene, specifically for the rs12979860 variant. 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 81283?

CPT 81283 can be used to describe the genetic analysis procedure that detects changes in the IFNL3 gene, specifically for the rs12979860 variant. This code is used when the lab analyst performs the technical steps to extract nucleic acids, amplify the gene, and detect the target genes using a specimen such as blood.

2. Official Description

The official description of CPT code 81283 is: ‘IFNL3 (interferon, lambda 3) (eg, drug response), gene analysis, rs12979860 variant.’

3. Procedure

1. The lab analyst performs the technical steps to extract nucleic acids from a specimen, such as blood.
2. The lab analyst amplifies the IFNL3 gene to increase and stabilize the quantity of nucleic acid for analysis.
3. The lab analyst detects the target genes, specifically the rs12979860 variant, using methods such as nucleic acid probes.

4. Qualifying circumstances

CPT 81283 is typically ordered for individuals with hepatitis C virus (HCV) genotype 1 infection to predict their response to certain drug treatments. However, it is not limited to testing for a specific condition. The test can be ordered by clinicians to detect changes in the IFNL3 gene, specifically for the rs12979860 variant.

5. When to use CPT code 81283

CPT code 81283 should be used when the lab analyst performs the genetic analysis procedure to detect changes in the IFNL3 gene, specifically for the rs12979860 variant. It is important to note that this code should not be used for testing related to a specific condition, but rather for the analysis of the IFNL3 gene.

6. Documentation requirements

To support a claim for CPT 81283, the documentation should include:

• Indication for the test, such as hepatitis C virus (HCV) genotype 1 infection or detection of changes in the IFNL3 gene
• Details of the technical steps performed by the lab analyst, including nucleic acid extraction, gene amplification, and target gene detection
• Specimen used for the analysis, such as blood

7. Billing guidelines

When billing for CPT 81283, ensure that the genetic analysis procedure is performed to detect changes in the IFNL3 gene, specifically for the rs12979860 variant. It is important to follow the specific guidelines provided by payers regarding the reporting of this code. Additionally, consider reporting any separate services, such as specimen collection or interpretation by a physician, if applicable.

8. Historical information

CPT 81283 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 genetic analysis procedure to detect changes in the IFNL3 gene, specifically for the rs12979860 variant, for an individual with hepatitis C virus (HCV) genotype 1 infection.
2. The lab analyst analyzes the IFNL3 gene to predict the response to certain drug treatments for an individual with a specific condition.
3. A clinician orders the genetic analysis procedure to detect changes in the IFNL3 gene, specifically for the rs12979860 variant, for an individual without a specific condition but with a family history of genetic disorders.
4. The lab analyst performs the genetic analysis procedure to detect changes in the IFNL3 gene, specifically for the rs12979860 variant, for research purposes.
5. A clinician orders the genetic analysis procedure to detect changes in the IFNL3 gene, specifically for the rs12979860 variant, for an individual with an unknown condition but suspected genetic susceptibility to certain drugs.
6. The lab analyst analyzes the IFNL3 gene to predict the response to certain drug treatments for an individual with a specific condition not related to hepatitis C virus (HCV) genotype 1 infection.
7. A clinician orders the genetic analysis procedure to detect changes in the IFNL3 gene, specifically for the rs12979860 variant, for an individual with a known genetic disorder.
8. The lab analyst performs the genetic analysis procedure to detect changes in the IFNL3 gene, specifically for the rs12979860 variant, for an individual with a family history of cancer.
9. A clinician orders the genetic analysis procedure to detect changes in the IFNL3 gene, specifically for the rs12979860 variant, for an individual with a specific condition not related to cancer susceptibility.
10. The lab analyst analyzes the IFNL3 gene to predict the response to certain drug treatments for an individual with a specific condition not related to genetic disorders.