How To Use CPT Code 81292

CPT 81292 describes the full sequence analysis of the MLH1 gene, also known as the mutL homolog 1 gene, which is associated with conditions such as hereditary nonpolyposis colorectal cancer (Lynch syndrome). 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 81292?

CPT 81292 is used to analyze the entire gene sequence of the MLH1 gene, which is responsible for conditions like Lynch syndrome. This code specifically involves the full sequence analysis of the MLH1 gene, rather than evaluating common variants.

2. Official Description

The official description of CPT code 81292 is: ‘MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis.’

3. Procedure

1. The lab analyst performs the technical lab test to analyze the entire gene sequence of the MLH1 gene.
2. This involves extracting nucleic acids from the sample, such as through cell lysis and digestion.
3. The lab analyst then amplifies and stabilizes the quantity of nucleic acid for analysis.
4. The target genes, in this case, the MLH1 gene, are detected using methods such as nucleic acid probes.
5. The full gene sequence analysis is performed, examining the specific nucleic acid sequence associated with the MLH1 gene.

4. Qualifying circumstances

CPT 81292 is commonly ordered by clinicians for the diagnosis of Lynch syndrome, also known as hereditary nonpolyposis colorectal cancer. It may also be ordered to evaluate the inheritance of genetic mutations in the MLH1 gene. The test is not limited to a specific condition but is often used in the context of Lynch syndrome, which increases the risk of various malignancies.

5. When to use CPT code 81292

CPT code 81292 should be used when the lab analyst performs the full sequence analysis of the MLH1 gene. This code is specifically for analyzing the entire gene sequence, not just evaluating common variants. If testing for known familial variants or duplication/deletion variants of the MLH1 gene, different codes should be used.

6. Documentation requirements

To support a claim for CPT 81292, documentation should include:

• Indication for the test, such as the diagnosis of Lynch syndrome or evaluation of MLH1 gene mutations
• Details of the technical steps performed, including nucleic acid extraction, amplification, and detection
• Date and time of the analysis
• Results of the full sequence analysis of the MLH1 gene
• Signature of the lab analyst performing the analysis

7. Billing guidelines

When billing for CPT 81292, ensure that the full sequence analysis of the MLH1 gene is performed. It is important to note that if the ordering clinician requests physician interpretation of the test and the pathologist provides an interpretation and report, an additional code may be reported for the interpretation. It is also crucial to use the appropriate codes for testing other genes associated with Lynch syndrome, such as MSH2.

8. Historical information

CPT 81292 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 patient undergoes CPT 81292 for the full sequence analysis of the MLH1 gene to diagnose Lynch syndrome.
2. A clinician orders CPT 81292 to evaluate the inheritance of genetic mutations in the MLH1 gene for a patient with a family history of Lynch syndrome.
3. A lab analyst performs CPT 81292 to analyze the entire gene sequence of the MLH1 gene for a patient suspected of having hereditary nonpolyposis colorectal cancer.
4. CPT 81292 is used to assess the MLH1 gene for known variants in a patient with a confirmed diagnosis of Lynch syndrome.
5. A clinician orders CPT 81292 to analyze the full sequence of the MLH1 gene in a patient with a suspected genetic predisposition to colorectal cancer.
6. For a patient with a family history of Lynch syndrome, CPT 81292 is performed to evaluate the MLH1 gene for potential mutations.
7. A lab analyst conducts CPT 81292 to analyze the entire gene sequence of the MLH1 gene for a patient with a history of Lynch syndrome-related cancers.
8. CPT 81292 is used to assess the MLH1 gene for duplication/deletion variants in a patient with suspected Lynch syndrome.
9. A clinician orders CPT 81292 to analyze the full sequence of the MLH1 gene in a patient with a personal history of colorectal cancer.
10. For a patient with a family history of Lynch syndrome, CPT 81292 is performed to evaluate the MLH1 gene for potential mutations.