How To Use CPT Code 81346

CPT 81346 describes the analysis of the TYMS (thymidylate synthetase) gene for common variants, such as the tandem repeat 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 81346?

CPT 81346 can be used to analyze the TYMS gene for common variants, specifically the tandem repeat variant. This code is used when the lab analyst performs the technical lab test to detect the presence of specific changes in the TYMS gene.

2. Official Description

The official description of CPT code 81346 is: ‘TYMS (thymidylate synthetase) (eg, 5-fluorouracil/5-FU drug metabolism), gene analysis, common variant(s) (eg, tandem repeat variant)’

3. Procedure

1. The lab analyst performs the technical lab test to detect the presence of specific changes in the TYMS gene, specifically for common variants like the tandem repeat variant.
2. The lab analyst extracts the nucleic acids from a specimen, such as blood or tumor cells, using methods like digestion and cell lysis.
3. The lab analyst amplifies the nucleic acids, increasing and stabilizing the quantity of the gene for analysis.
4. The lab analyst detects the target genes using methods like nucleic acid probes.
5. The lab analyst uses a specimen, such as blood or tumor cells, to perform the analysis.

4. Qualifying circumstances

CPT 81346 is used when clinicians order the test to evaluate potential responsiveness or toxicity to the chemotherapeutic agent 5-fluorouracil (5-FU) in individuals with solid tumors, such as colorectal cancer. The presence of mutations, such as the TYMS tandem repeat, may lead to 5-FU drug resistance and toxicity.

5. When to use CPT code 81346

CPT code 81346 should be used when there is a clinical need to analyze the TYMS gene for common variants, specifically the tandem repeat variant. It is important to ensure that the test is ordered for individuals with solid tumors, such as colorectal cancer, to evaluate potential responsiveness or toxicity to 5-FU.

6. Documentation requirements

To support a claim for CPT 81346, documentation should include:

• Reason for ordering the test, such as evaluating potential responsiveness or toxicity to 5-FU
• Specific gene analysis performed, including the detection of common variants like the tandem repeat variant
• Date and time of the test
• Specimen used for the analysis, such as blood or tumor cells
• Results of the analysis, including any mutations or variants detected
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 81346, ensure that the test is performed by a lab analyst and that the analysis is specifically for the TYMS gene and its common variants, such as the tandem repeat variant. It is important to follow any additional guidelines provided by payers regarding specimen collection and prep work. If the ordering clinician requests physician interpretation of the test, an additional code may be reported.

8. Historical information

CPT 81346 was added to the Current Procedural Terminology system on January 1, 2018. There have been no updates to the code since its addition.

9. Examples

1. A lab analyst performing the analysis of the TYMS gene for the tandem repeat variant in a patient with colorectal cancer to evaluate potential responsiveness or toxicity to 5-FU.
2. A lab analyst analyzing the TYMS gene for common variants, including the tandem repeat variant, in a patient with a solid tumor to assess their potential response to 5-FU.
3. A lab analyst performing the analysis of the TYMS gene for the tandem repeat variant in a patient with colorectal cancer to determine their susceptibility to 5-FU drug resistance and toxicity.
4. A lab analyst analyzing the TYMS gene for common variants, such as the tandem repeat variant, in a patient with a solid tumor to assess their risk of experiencing adverse effects from 5-FU.
5. A lab analyst performing the analysis of the TYMS gene for the tandem repeat variant in a patient with colorectal cancer to guide the selection of appropriate chemotherapy treatment.
6. A lab analyst analyzing the TYMS gene for common variants, including the tandem repeat variant, in a patient with a solid tumor to inform the choice of chemotherapy regimen.
7. A lab analyst performing the analysis of the TYMS gene for the tandem repeat variant in a patient with colorectal cancer to personalize their chemotherapy treatment based on their genetic profile.
8. A lab analyst analyzing the TYMS gene for common variants, such as the tandem repeat variant, in a patient with a solid tumor to tailor their chemotherapy regimen to their individual genetic characteristics.
9. A lab analyst performing the analysis of the TYMS gene for the tandem repeat variant in a patient with colorectal cancer to optimize the effectiveness and minimize the toxicity of their chemotherapy treatment.