How To Use CPT Code 81308

CPT 81308 describes the analysis of the partner and localizer of BRCA2 (PALB2) gene for a known familial variant. 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 81308?

CPT 81308 can be used to analyze the PALB2 gene for specific, known familial variants that may be associated with autosomal-dominant forms of diseases such as breast and pancreatic cancer. This code is used when a lab analyst performs the technical steps to extract nucleic acids from a specimen, amplify the quantity of nucleic acid for analysis, and detect the target genes.

2. Official Description

The official description of CPT code 81308 is: ‘PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) gene analysis; known familial variant.’

3. Procedure

1. The lab analyst extracts nucleic acids from a specimen, such as blood, using methods like cell lysis and digestion.
2. The lab analyst amplifies and stabilizes the quantity of nucleic acid for analysis by techniques like polymerase chain reaction (PCR).
3. The lab analyst detects the target genes, specifically analyzing the PALB2 gene for known familial variants associated with autosomal-dominant forms of diseases.

4. Qualifying circumstances

CPT 81308 is ordered for patients with a strong family history of breast or pancreatic cancer, particularly those with a known mutation in a family member. The analysis of the PALB2 gene is performed to identify specific known familial variants that may increase the risk of breast, pancreatic, and possibly ovarian cancer. This test is not limited to a specific condition and can be ordered by clinicians for patients with relevant family history.

5. When to use CPT code 81308

CPT code 81308 should be used when analyzing the PALB2 gene for known familial variants associated with autosomal-dominant forms of diseases. It is appropriate to bill this code when the lab analyst performs the technical steps to extract nucleic acids, amplify the quantity of nucleic acid, and detect the target genes. This code should not be reported separately if the lab performs a gene panel test that includes PALB2.

6. Documentation requirements

To support a claim for CPT 81308, documentation should include:

• Indication of the patient’s strong family history of breast or pancreatic cancer
• Specific known familial variants being analyzed in the PALB2 gene
• Details of the technical steps performed by the lab analyst, including specimen extraction, nucleic acid amplification, and target gene detection

7. Billing guidelines

When billing for CPT 81308, ensure that the analysis is performed for known familial variants associated with autosomal-dominant forms of diseases. If the ordering clinician requests physician interpretation and the pathologist provides an interpretation and report, additional codes such as G0452 with modifier 26 may be reported. It is important to distinguish between code 81307 for PALB2 full gene sequence analysis and code 81308 for PALB2 known familial variant analysis. If the lab performs a gene panel test that includes PALB2, do not separately report code 81308.

8. Historical information

CPT 81308 was added to the Current Procedural Terminology system on January 1, 2020. There have been no updates to the code since its addition.

9. Examples

1. A lab analyst performing the analysis of the PALB2 gene for a known familial variant associated with breast cancer in a patient with a strong family history of the disease.
2. An analysis of the PALB2 gene for a known familial variant associated with pancreatic cancer in a patient with a family member who has been diagnosed with the disease.
3. The detection of specific known familial variants in the PALB2 gene to assess the risk of breast and pancreatic cancer in a patient with a relevant family history.
4. An analysis of the PALB2 gene for a known familial variant associated with breast and ovarian cancer in a patient with a family history of both diseases.
5. The identification of specific known familial variants in the PALB2 gene to evaluate the risk of breast, pancreatic, and ovarian cancer in a patient with a strong family history of these diseases.
6. An analysis of the PALB2 gene for a known familial variant associated with breast cancer in a patient with a family member who has tested positive for the same variant.
7. The detection of specific known familial variants in the PALB2 gene to assess the risk of pancreatic cancer in a patient with a family history of the disease.
8. An analysis of the PALB2 gene for a known familial variant associated with breast and pancreatic cancer in a patient with a strong family history of both diseases.
9. The identification of specific known familial variants in the PALB2 gene to evaluate the risk of breast and ovarian cancer in a patient with a relevant family history.
10. An analysis of the PALB2 gene for a known familial variant associated with pancreatic cancer in a patient with a family member who has been diagnosed with the disease.