How To Use CPT Code 81287

CPT 81287 describes the analysis of MGMT (O-6-methylguanine-DNA methyltransferase) promoter methylation, which is often used as a prognostic marker for the responsiveness of glioblastoma (a type of brain tumor) to alkylating chemotherapy using temozolomide. 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 81287?

CPT 81287 is a code used to describe the analysis of MGMT promoter methylation. This analysis is typically performed to determine the responsiveness of glioblastoma, a type of brain tumor, to alkylating chemotherapy using temozolomide. The presence or absence of MGMT promoter methylation can serve as a prognostic indicator for the effectiveness of this treatment.

2. Official Description

The official description of CPT code 81287 is not provided. However, this code is used for the analysis of MGMT promoter methylation, which involves evaluating the methylation status of the promoter region of the MGMT gene.

3. Procedure

1. The lab analyst performs all technical steps involved in the analysis of MGMT promoter methylation.
2. This includes extracting nucleic acids from a specimen, such as brain tumor tissue, using methods like cell lysis and digestion.
3. The quantity of nucleic acid is increased and stabilized for analysis through processes like amplification using methylation-specific polymerase chain reaction (PCR).
4. The specimen is evaluated for methylation of the promoter region of the MGMT gene.

4. Qualifying circumstances

CPT 81287 is typically ordered for patients with glioblastoma multiforme, the most common and malignant primary brain tumor in adults. MGMT promoter methylation analysis is particularly important for patients over 60 years of age, as it can serve as a prognostic indicator of their response to chemotherapy with alkylating drugs like temozolomide.

5. When to use CPT code 81287

CPT code 81287 should be used when performing the analysis of MGMT promoter methylation. It is appropriate to bill this code when evaluating the methylation status of the MGMT gene promoter region to assess the potential responsiveness of glioblastoma to alkylating chemotherapy using temozolomide.

6. Documentation requirements

To support a claim for CPT code 81287, the following documentation is typically required:

• Indication for the analysis, such as the patient’s diagnosis of glioblastoma multiforme
• Details of the specimen used for analysis, including the source (e.g., brain tumor tissue)
• Methodology used for the analysis, such as methylation-specific PCR
• Results of the analysis, indicating the presence or absence of MGMT promoter methylation
• Signature of the lab analyst performing the analysis

7. Billing guidelines

When billing for CPT code 81287, ensure that the analysis of MGMT promoter methylation is performed. It is important to follow the specific documentation requirements and guidelines provided by the payer. Additionally, consider any applicable modifiers or additional codes that may need to be reported in conjunction with CPT code 81287.

8. Historical information

CPT code 81287 was added to the Current Procedural Terminology system on January 1, 2014. There have been no updates or changes to the code since its addition.

9. Examples

1. A lab analyst performs the analysis of MGMT promoter methylation in a specimen from a patient diagnosed with glioblastoma multiforme to determine their potential responsiveness to temozolomide chemotherapy.
2. The methylation status of the MGMT gene promoter region is evaluated in a brain tumor tissue sample from a patient with glioblastoma to assess their prognosis and treatment options.
3. Using methylation-specific PCR, the lab analyst analyzes the MGMT promoter methylation in a specimen from a patient with glioblastoma to guide the selection of appropriate chemotherapy.
4. A brain tumor tissue sample is assessed for MGMT promoter methylation to determine the potential effectiveness of alkylating chemotherapy using temozolomide in a patient with glioblastoma.
5. The presence or absence of MGMT promoter methylation is evaluated in a specimen from a patient with glioblastoma to predict their response to specific treatment options.
6. A lab performs the analysis of MGMT promoter methylation in a brain tumor tissue sample to provide valuable prognostic information for a patient diagnosed with glioblastoma multiforme.
7. The methylation status of the MGMT gene promoter region is assessed in a specimen from a patient with glioblastoma to aid in treatment decision-making and prognosis.
8. Using methylation-specific PCR, the lab analyst analyzes the MGMT promoter methylation in a brain tumor tissue sample to determine the patient’s potential responsiveness to alkylating chemotherapy.
9. A brain tumor tissue specimen is evaluated for MGMT promoter methylation to guide the selection of appropriate treatment options for a patient diagnosed with glioblastoma.
10. The presence or absence of MGMT promoter methylation is assessed in a specimen from a patient with glioblastoma to provide valuable information for personalized treatment planning.