How To Use CPT Code 81364

CPT 81364 describes the full gene sequence analysis for the hemoglobin, subunit beta (HBB) 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 81364?

CPT 81364 can be used to describe the full gene sequence analysis for the HBB gene. This code is used when a lab analyst performs the technical lab test to analyze the entire gene sequence for the HBB gene. The analysis helps in confirming suspected conditions related to a genetic mutation in the HBB gene, such as beta thalassemia or other hemoglobinopathies.

2. Official Description

The official description of CPT code 81364 is: ‘HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); full gene sequence.’

3. Procedure

1. The lab analyst extracts the nucleic acids from the specimen, such as blood, using methods like digestion and cell lysis.
2. The lab analyst amplifies the nucleic acids, increasing and stabilizing the quantity of nucleic acid for analysis.
3. The lab analyst detects the target genes, such as the HBB gene, using methods like nucleic acid probes.
4. The lab analyst performs a full gene sequence analysis for the HBB gene, analyzing the entire gene sequence.

4. Qualifying circumstances

CPT 81364 is used when there is a need to analyze the full gene sequence of the HBB gene to confirm suspected conditions related to a genetic mutation in the HBB gene, such as beta thalassemia or other hemoglobinopathies. This analysis helps in understanding the structure and function of hemoglobin and identifying any alterations or mutations in the HBB gene.

5. When to use CPT code 81364

CPT code 81364 should be used when there is a need to perform a full gene sequence analysis for the HBB gene. It is appropriate to use this code when confirming suspected conditions related to a genetic mutation in the HBB gene, such as beta thalassemia or other hemoglobinopathies. This code should not be used for testing specific conditions but rather for analyzing the entire gene sequence.

6. Documentation requirements

To support a claim for CPT 81364, the documentation should include:

• Reason for ordering the test and suspected conditions related to a genetic mutation in the HBB gene
• Details of the technical steps performed by the lab analyst, including nucleic acid extraction, amplification, and detection
• Specimen used for the analysis, such as blood
• Results of the full gene sequence analysis for the HBB gene
• Signature of the lab analyst performing the analysis

7. Billing guidelines

When billing for CPT 81364, ensure that the full gene sequence analysis for the HBB gene is performed. This code should not be reported with other codes in the HBB genetic analysis family, such as CPT 81361 for common variants, CPT 81362 for known familial variants, or CPT 81363 for duplication deletion analysis. Additionally, consider reporting separate codes for specimen collection or prep work, if applicable.

8. Historical information

CPT 81364 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 a full gene sequence analysis for the HBB gene to confirm beta thalassemia in a patient.
2. An analysis of the entire gene sequence of the HBB gene to identify any mutations related to sickle cell anemia.
3. A full gene sequence analysis for the HBB gene to confirm a hemoglobinopathy in a patient.
4. An analysis of the HBB gene to understand the structure and function of hemoglobin in a research study.
5. A lab analyst performing a full gene sequence analysis for the HBB gene to investigate a suspected genetic mutation in a patient.
6. An analysis of the entire gene sequence of the HBB gene to determine the presence of beta thalassemia in a newborn.
7. A full gene sequence analysis for the HBB gene to identify any alterations in the gene associated with a specific hemoglobinopathy.
8. An analysis of the HBB gene to confirm a genetic mutation in a patient with a family history of beta thalassemia.
9. A lab analyst performing a full gene sequence analysis for the HBB gene to study the prevalence of hemoglobinopathies in a population.
10. An analysis of the entire gene sequence of the HBB gene to investigate the impact of genetic mutations on hemoglobin function.