How To Use CPT Code 81352

CPT 81352 describes the targeted sequence analysis of the TP53 gene, which is used to identify mutations associated with Li-Fraumeni syndrome. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 81352?

CPT 81352 is a code used to describe the targeted sequence analysis of the TP53 gene. This analysis is performed on a specimen, such as blood, to identify specific gene sequences that may indicate a diagnosis of Li-Fraumeni syndrome. The test helps to determine if there are mutations in the TP53 gene that may contribute to the development of multiple cancers at an early age. The results of this analysis may also indicate the need for testing family members for similar mutations.

2. Official Description

The official description of CPT code 81352 is: ‘TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; targeted sequence analysis (eg, 4 oncology)’

3. Procedure

1. The lab analyst performs the technical lab test on a specimen, such as blood, to analyze targeted gene sequences for the TP53 gene.
2. The lab analyst extracts the nucleic acids from the specimen using methods such as cell lysis and digestion.
3. The lab analyst amplifies and stabilizes the quantity of nucleic acid for analysis using a method such as polymerase chain reaction (PCR).
4. The lab analyst detects the target genes and analyzes the sequences to identify any mutations associated with Li-Fraumeni syndrome.

4. Qualifying circumstances

CPT 81352 is used when there is a clinical suspicion of Li-Fraumeni syndrome and the clinician wants to confirm the diagnosis by evaluating germline mutations in the TP53 gene. Li-Fraumeni syndrome is an inherited condition that may lead to the early onset of multiple cancers. The test is performed on individuals who may have a family history of cancer or who exhibit symptoms consistent with the syndrome. The analysis is typically ordered by a clinician, and the results may indicate the need for predictive testing for family members.

5. When to use CPT code 81352

CPT code 81352 should be used when there is a clinical suspicion of Li-Fraumeni syndrome and the targeted sequence analysis of the TP53 gene is necessary to confirm the diagnosis. It is important to note that this code should not be used for full gene sequence analysis (CPT 81351) or known familial variants (CPT 81353).

6. Documentation requirements

To support a claim for CPT 81352, the documentation should include:

• Clinical indication for the test, such as a suspected diagnosis of Li-Fraumeni syndrome
• Details of the specimen used for analysis, such as blood
• Methods used for nucleic acid extraction and amplification
• Results of the targeted sequence analysis, including any identified mutations
• Signature of the lab analyst performing the analysis

7. Billing guidelines

When billing for CPT 81352, it is important to ensure that the analysis is performed on targeted gene sequences for the TP53 gene. This code should not be reported if the analysis is part of a gene panel test that includes TP53. Additionally, there may be separate codes for specimen collection or processing, depending on the payer’s guidelines. If the ordering clinician requests physician interpretation of the test, an additional code may be reported for the interpretation.

8. Historical information

CPT 81352 was added to the Current Procedural Terminology system on January 1, 2021. There have been no updates to the code since its addition.

9. Examples

1. A patient with a family history of multiple cancers undergoes targeted sequence analysis of the TP53 gene to confirm a suspected diagnosis of Li-Fraumeni syndrome.
2. A clinician orders CPT 81352 for a patient who presents with early-onset breast cancer and wants to evaluate the possibility of a TP53 gene mutation.
3. A family member of an individual diagnosed with Li-Fraumeni syndrome undergoes targeted sequence analysis of the TP53 gene to determine if they carry the same mutation.
4. A patient with a history of multiple cancers undergoes targeted sequence analysis of the TP53 gene to identify any additional mutations that may contribute to their condition.
5. A clinician orders CPT 81352 for a patient with a family history of Li-Fraumeni syndrome and wants to assess their risk of developing multiple cancers.
6. A patient with a suspected diagnosis of Li-Fraumeni syndrome undergoes targeted sequence analysis of the TP53 gene to confirm the presence of mutations associated with the syndrome.
7. A clinician orders CPT 81352 for a patient who presents with a rare cancer and wants to evaluate the possibility of a TP53 gene mutation.
8. A family member of an individual diagnosed with Li-Fraumeni syndrome undergoes targeted sequence analysis of the TP53 gene to determine if they have inherited the same mutation.
9. A patient with a history of early-onset cancers undergoes targeted sequence analysis of the TP53 gene to identify any underlying genetic mutations.
10. A clinician orders CPT 81352 for a patient with a family history of Li-Fraumeni syndrome and wants to assess their risk of developing multiple cancers.