How To Use CPT Code 81297

CPT 81297 describes the genetic analysis procedure for detecting duplication and deletion variants in the MSH2 gene, also known as the colon cancer or nonpolyposis type 1 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 81297?

CPT 81297 can be used to describe the genetic analysis procedure performed by a laboratory analyst to detect duplication and deletion variants in the MSH2 gene. This gene is associated with conditions such as hereditary nonpolyposis colorectal cancer, also known as Lynch syndrome. The test involves analyzing the gene sequence to determine if there are any changes in the copy number of the gene, indicating duplication or deletion.

2. Official Description

The official description of CPT code 81297 is: ‘MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants.’

3. Procedure

1. The laboratory analyst performs all technical steps to analyze the MSH2 gene for duplication and deletion changes in the gene sequence.
2. This includes extracting nucleic acids from the sample, amplifying the DNA to increase its quantity, and using nucleic acid probes and electrophoresis to determine if there are any changes in the copy number of the gene.
3. The analysis aims to identify if there are three or more copies (duplication) or one or zero copies (deletion) of the MSH2 gene, instead of the normal copy number of two.

4. Qualifying circumstances

CPT 81297 is typically ordered for patients suspected of having MSH2 mutations who have tested negative for mutations using full gene analysis. It is commonly used for the diagnosis or predictive genetic testing of Lynch syndrome, a hereditary condition that increases the risk of colorectal and other types of cancer. The test is performed by a laboratory analyst and requires a sample containing the MSH2 gene.

5. When to use CPT code 81297

CPT code 81297 should be used when a genetic analysis is performed specifically to detect duplication and deletion variants in the MSH2 gene. It is not appropriate to use this code for other types of genetic analysis or when testing for different genes. The test is typically ordered when there is a suspicion of MSH2 mutations or for the diagnosis and predictive genetic testing of Lynch syndrome.

6. Documentation requirements

To support a claim for CPT 81297, documentation should include:

• Indication for the test, such as suspicion of MSH2 mutations or diagnosis/predictive testing for Lynch syndrome
• Details of the technical steps performed by the laboratory analyst, including extraction, amplification, and analysis of the MSH2 gene
• Results of the analysis, indicating the presence or absence of duplication or deletion variants
• Signature of the laboratory analyst performing the test

7. Billing guidelines

When billing for CPT 81297, ensure that the test is specifically performed to detect duplication and deletion variants in the MSH2 gene. It should not be reported for other types of genetic analysis or when testing for different genes. If the ordering clinician separately requests physician interpretation of the test, it may be appropriate to report an additional code for the interpretation. It is important to follow the specific guidelines of the payer when reporting this code.

8. Historical information

CPT 81297 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 laboratory analyst performs a genetic analysis on a patient’s sample to detect duplication or deletion variants in the MSH2 gene, indicating a potential risk for Lynch syndrome.
2. A clinician orders a genetic test specifically for the analysis of duplication and deletion variants in the MSH2 gene for a patient with a family history of colorectal cancer.
3. A patient undergoes genetic testing to determine if there are any changes in the copy number of the MSH2 gene, which could indicate a higher risk for developing Lynch syndrome.
4. A laboratory analyst analyzes the MSH2 gene for duplication and deletion variants in a patient’s sample to provide information for the diagnosis or predictive testing of Lynch syndrome.
5. A clinician orders a genetic analysis specifically for the detection of duplication or deletion variants in the MSH2 gene to assess the patient’s risk for developing colorectal and other associated cancers.
6. A patient undergoes genetic testing to determine if there are any changes in the copy number of the MSH2 gene, which could indicate a hereditary predisposition to Lynch syndrome.
7. A laboratory analyst performs a genetic analysis on a patient’s sample to identify any duplication or deletion variants in the MSH2 gene, providing valuable information for the management and treatment of Lynch syndrome.
8. A clinician orders a genetic test specifically for the analysis of duplication and deletion variants in the MSH2 gene for a patient with a suspected hereditary predisposition to colorectal cancer.
9. A patient undergoes genetic testing to assess the presence of duplication or deletion variants in the MSH2 gene, which could indicate an increased risk for Lynch syndrome and other associated cancers.
10. A laboratory analyst analyzes the MSH2 gene for duplication and deletion variants in a patient’s sample, contributing to the identification and management of Lynch syndrome in individuals and their families.