How To Use CPT Code 81353

CPT 81353 describes the analysis of known familial variants for the tumor protein 53 (TP53) gene. 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 81353?

CPT 81353 is used to analyze known familial variants for the TP53 gene. This test is performed on a specimen, such as blood, to evaluate family members for germline mutations associated with Li-Fraumeni syndrome, a hereditary condition that may lead to the early onset of multiple cancers. The analysis focuses on specific gene sequences related to TP53.

2. Official Description

The official description of CPT code 81353 is: ‘TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome) gene analysis; known familial variant.’

3. Procedure

1. The lab analyst performs technical steps to analyze known familial variants of the TP53 gene using a specimen, such as blood.
2. The process involves extracting nucleic acids from the specimen through methods like cell lysis and digestion.
3. The lab analyst then amplifies and stabilizes the quantity of nucleic acid for analysis using techniques like polymerase chain reaction (PCR).
4. The target genes, specifically TP53 gene sequences, are detected and analyzed.

4. Qualifying circumstances

CPT 81353 is ordered by clinicians to evaluate germline mutations in family members for the diagnosis and predictive testing of Li-Fraumeni syndrome. This test is not limited to a specific condition but focuses on TP53 gene variants. Germline mutations are inherited and occur in reproductive cells, affecting all cells in the child’s body. TP53 is a tumor suppressor gene, and mutations in this gene can contribute to various types of cancer.

5. When to use CPT code 81353

CPT code 81353 should be used when analyzing known familial variants of the TP53 gene. It is ordered to evaluate germline mutations in family members for the diagnosis and predictive testing of Li-Fraumeni syndrome. This code is specific to the analysis of TP53 gene sequences and should not be used for other gene analysis procedures.

6. Documentation requirements

To support a claim for CPT 81353, documentation should include:

• Indication of the need for TP53 gene analysis
• Details of the known familial variants being analyzed
• Date and time of the analysis
• Results of the analysis
• Signature of the lab analyst performing the analysis

7. Billing guidelines

When billing for CPT 81353, ensure that the analysis is performed on known familial variants of the TP53 gene. It is important to follow specific guidelines for reporting this code and to avoid reporting it with other TP53 gene analysis codes, such as CPT 81351 for full gene sequence analysis or CPT 81352 for targeted sequence analysis. Additionally, if the lab performs a gene panel test that includes TP53, do not separately report CPT 81353.

8. Historical information

CPT 81353 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 Li-Fraumeni syndrome undergoes TP53 gene analysis to evaluate known familial variants.
2. A clinician orders TP53 gene analysis for a family member of a patient diagnosed with Li-Fraumeni syndrome to assess the risk of developing multiple cancers.
3. A genetic counselor recommends TP53 gene analysis for a family with a history of early-onset cancers to identify known familial variants.
4. A patient with a TP53 gene variant undergoes TP53 gene analysis to determine the specific variant and its implications for cancer risk.
5. A research study includes TP53 gene analysis to investigate the prevalence of known familial variants in a population at high risk for Li-Fraumeni syndrome.