How To Use CPT Code 81412

CPT 81412 describes the genomic sequence analysis panel used to evaluate genetic sequences of at least nine genes associated with disorders commonly found in individuals of Ashkenazi Jewish descent. 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 81412?

CPT 81412 can be used to describe the genomic sequence analysis panel performed by a laboratory analyst to evaluate genetic sequences of at least nine specific genes. This code is used to identify disorders that are more prevalent in individuals of Ashkenazi Jewish descent. The test involves analyzing a patient’s specimen, such as blood, using specialized equipment to determine the order of nucleotides in DNA. The results are compared to a reference genome to identify any variants or mutations associated with certain conditions.

2. Official Description

The official description of CPT code 81412 is: ‘Ashkenazi Jewish associated disorders (eg, Bloom syndrome, Canavan disease, cystic fibrosis, familial dysautonomia, Fanconi anemia group C, Gaucher disease, Tay-Sachs disease), genomic sequence analysis panel, must include sequencing of at least 9 genes, including ASPA, BLM, CFTR, FANCC, GBA, HEXA, IKBKAP, MCOLN1, and SMPD1.’

3. Procedure

1. The laboratory analyst receives a patient specimen, such as blood, for genomic sequence analysis.
2. Using specialized equipment, such as a next-generation gene sequencer, the analyst performs a genomic sequence analysis of at least nine specific genes.
3. The instrument generates a readout of the nucleotide sequence, which is compared to a reference genome to identify any variants or mutations.
4. The analyst analyzes the results and identifies any genetic sequences associated with disorders commonly found in individuals of Ashkenazi Jewish descent.
5. A report is generated, detailing the findings of the genomic sequence analysis panel.

4. Qualifying circumstances

CPT 81412 is used for patients who are being evaluated for genetic disorders that are more prevalent in individuals of Ashkenazi Jewish descent. The test is ordered as part of genetic counseling and evaluation for conditions such as Bloom syndrome, Canavan disease, cystic fibrosis, familial dysautonomia, Fanconi anemia group C, Gaucher disease, and Tay-Sachs disease. The patient’s Ashkenazi Jewish heritage and the presence of symptoms or family history of these disorders may qualify them for this test.

5. When to use CPT code 81412

CPT code 81412 should be used when a genomic sequence analysis panel is performed to evaluate genetic sequences of at least nine specific genes associated with disorders commonly found in individuals of Ashkenazi Jewish descent. This code should be used when the test is ordered as part of genetic counseling and evaluation for these specific conditions. It is important to ensure that the test includes sequencing of all nine genes listed in the code description.

6. Documentation requirements

To support a claim for CPT 81412, the documentation should include:

• Indication for the test, such as a family history of Ashkenazi Jewish associated disorders or the presence of symptoms
• Details of the genomic sequence analysis panel, including the specific genes sequenced
• Date of the test and the laboratory where it was performed
• Results of the analysis, including any variants or mutations identified
• Interpretation of the results and their significance in relation to the patient’s condition
• Signature of the laboratory analyst performing the test

7. Billing guidelines

When billing for CPT 81412, ensure that the test includes sequencing of at least nine specific genes associated with Ashkenazi Jewish associated disorders. It is important to follow the specific code description and include all necessary components of the test. Additional molecular pathology codes should not be reported for the same genes included in CPT 81412. However, other codes may be used for testing involving different genes not covered by CPT 81412. It is also important to consider any specific billing guidelines provided by payers regarding this test.

8. Historical information

CPT 81412 was added to the Current Procedural Terminology system on January 1, 2016. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient of Ashkenazi Jewish descent undergoes a genomic sequence analysis panel that includes sequencing of ASPA, BLM, CFTR, FANCC, GBA, HEXA, IKBKAP, MCOLN1, and SMPD1 genes to evaluate their risk for various genetic disorders.
2. A couple with Ashkenazi Jewish heritage undergoes genetic testing as part of family planning, including a genomic sequence analysis panel to assess their risk of passing on certain genetic disorders.
3. A patient presents with symptoms associated with Ashkenazi Jewish associated disorders, and their healthcare provider orders a genomic sequence analysis panel to identify any genetic variants or mutations.
4. A newborn baby with Ashkenazi Jewish ancestry undergoes genetic testing, including a genomic sequence analysis panel, to screen for specific genetic disorders prevalent in this population.
5. A patient with a family history of Ashkenazi Jewish associated disorders undergoes a genomic sequence analysis panel to determine their risk of developing these conditions.