How To Use CPT Code 81325

CPT 81325 describes the full sequence analysis of the PMP22 gene, which is responsible for peripheral myelin protein 22. 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 81325?

CPT 81325 can be used to analyze the entire gene sequence of the PMP22 gene, specifically for conditions such as Charcot-Marie-Tooth or hereditary neuropathy with liability to pressure palsies. This code is used when the lab analyst performs all technical steps, from extracting nucleic acids to detecting target genes, to provide a comprehensive analysis of the PMP22 gene.

2. Official Description

The official description of CPT code 81325 is: ‘PMP22 (peripheral myelin protein 22) gene analysis; full sequence analysis.’

3. Procedure

1. The lab analyst performs technical steps, including extracting nucleic acids and amplifying the quantity of nucleic acid for analysis.
2. The lab analyst analyzes the full gene sequence of the PMP22 gene, not just specific variants or duplication/deletion mutations.
3. The lab analyst detects the target genes using methods such as nucleic acid probes.

4. Qualifying circumstances

CPT 81325 is commonly ordered by clinicians for the diagnosis of conditions such as Charcot-Marie-Tooth or hereditary neuropathy with liability to pressure palsies. It is typically ordered when the results of CPT code 81324 are negative, as the most common PMP22 mutations involved in these conditions are due to duplications or deletions of DNA.

5. When to use CPT code 81325

CPT code 81325 should be used when a comprehensive analysis of the full gene sequence of the PMP22 gene is required. It is appropriate for diagnosing conditions such as Charcot-Marie-Tooth or hereditary neuropathy with liability to pressure palsies. This code should not be used for evaluating specific variants or duplication/deletion mutations.

6. Documentation requirements

To support a claim for CPT 81325, documentation should include:

• Reason for ordering the test and the specific condition being evaluated
• Details of the technical steps performed by the lab analyst
• Date and time of the analysis
• Results of the full gene sequence analysis
• Signature of the lab analyst performing the analysis

7. Billing guidelines

When billing for CPT 81325, ensure that the analysis is performed for the full gene sequence of the PMP22 gene. This code should not be reported with other codes unless necessary. It is important to follow the specific guidelines provided by the payer and to accurately document the analysis performed.

8. Historical information

CPT 81325 was added to the Current Procedural Terminology system on January 1, 2013. There have been no updates to the code since its addition.

9. Examples

1. A lab analyst performing a full sequence analysis of the PMP22 gene for a patient suspected to have Charcot-Marie-Tooth disease.
2. An analysis of the PMP22 gene performed to diagnose hereditary neuropathy with liability to pressure palsies in a patient with symptoms of numbness and tingling in the extremities.
3. A comprehensive analysis of the full gene sequence of the PMP22 gene ordered for a patient with suspected peripheral neuropathy.
4. An analysis of the PMP22 gene performed to confirm a diagnosis of Charcot-Marie-Tooth disease in a patient with muscle weakness and atrophy.
5. A lab analyst conducting a full sequence analysis of the PMP22 gene to evaluate a patient with a family history of hereditary neuropathy.
6. An analysis of the PMP22 gene ordered to investigate the cause of a patient’s sensory loss and muscle weakness.
7. A comprehensive analysis of the full gene sequence of the PMP22 gene performed for a patient with symptoms of peripheral neuropathy.
8. An analysis of the PMP22 gene ordered to confirm a diagnosis of hereditary neuropathy with liability to pressure palsies in a patient with recurrent nerve palsies.
9. A lab analyst conducting a full sequence analysis of the PMP22 gene for a patient with suspected Charcot-Marie-Tooth disease based on clinical symptoms.
10. An analysis of the PMP22 gene performed to evaluate a patient with progressive muscle weakness and loss of sensation in the extremities.