How To Use CPT Code 81301

CPT 81301 describes the analysis of microsatellite instability (MSI) in tumor cells to detect markers for mismatch repair deficiency, such as BAT25 and BAT26. 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 81301?

CPT 81301 is used to analyze microsatellite instability (MSI) in tumor cells to identify markers for mismatch repair deficiency. This test helps in the diagnosis of conditions such as hereditary non-polyposis colorectal cancer (Lynch syndrome). It involves the comparison of neoplastic (tumor) and normal tissue to determine the presence of MSI markers.

2. Official Description

The official description of CPT code 81301 is: ‘Microsatellite instability analysis (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) of markers for mismatch repair deficiency (eg, BAT25, BAT26), includes comparison of neoplastic and normal tissue, if performed.’

3. Procedure

1. The lab analyst performs the technical steps of the test, including the extraction of nucleic acids from tissue specimens and the amplification of the target genes.
2. The lab analyst then evaluates the specimen for specific sequences of DNA with repetitive short nucleotide sequences, known as mismatch repair markers.
3. If the test is performed on both tumor and normal tissue, one unit of CPT 81301 represents both tests.

4. Qualifying circumstances

CPT 81301 is commonly ordered as an initial diagnostic tool for patients suspected of having Lynch syndrome or hereditary nonpolyposis colorectal cancer. Positive results indicate the need for further genetic testing for Lynch syndrome.

5. When to use CPT code 81301

CPT code 81301 should be used when analyzing microsatellite instability in tumor cells to detect markers for mismatch repair deficiency. It is appropriate for patients suspected of having Lynch syndrome or hereditary nonpolyposis colorectal cancer.

6. Documentation requirements

To support a claim for CPT 81301, documentation should include:

• Indication for the test, such as suspicion of Lynch syndrome or hereditary nonpolyposis colorectal cancer
• Details of the technical steps performed by the lab analyst
• Results of the analysis, including the presence or absence of MSI markers
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 81301, ensure that the test is performed to analyze microsatellite instability in tumor cells and detect markers for mismatch repair deficiency. It should not be reported with other codes unless additional services, such as tissue selection or interpretation by a physician, are separately documented and performed.

8. Historical information

CPT 81301 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 with suspected Lynch syndrome undergoes CPT 81301 to analyze microsatellite instability in tumor cells and detect markers for mismatch repair deficiency.
2. CPT 81301 is performed on a tissue specimen from a patient with suspected hereditary nonpolyposis colorectal cancer to determine the presence of MSI markers.
3. A physician orders CPT 81301 to analyze microsatellite instability in tumor cells and assess the risk of Lynch syndrome in a patient with a family history of colorectal cancer.
4. CPT 81301 is used to detect markers for mismatch repair deficiency in tumor cells from a patient with suspected hereditary nonpolyposis colorectal cancer.
5. A pathologist performs CPT 81301 on a tissue sample to identify MSI markers and aid in the diagnosis of Lynch syndrome.
6. A patient with a history of colorectal cancer undergoes CPT 81301 to assess the risk of Lynch syndrome and guide further genetic testing.
7. CPT 81301 is performed on tumor cells from a patient with suspected hereditary nonpolyposis colorectal cancer to determine the presence of MSI markers.
8. A physician orders CPT 81301 to analyze microsatellite instability in tumor cells and evaluate the risk of Lynch syndrome in a patient with a family history of Lynch syndrome.
9. CPT 81301 is used to detect markers for mismatch repair deficiency in tumor cells from a patient with suspected hereditary nonpolyposis colorectal cancer.
10. A pathologist performs CPT 81301 on a tissue sample to identify MSI markers and aid in the diagnosis of Lynch syndrome.