How To Use CPT Code 81419

CPT 81419 describes the genomic sequence analysis panel for epilepsy, which includes the analysis of at least 24 specific genes associated with the condition. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 81419?

CPT 81419 is used to describe the genomic sequence analysis panel for epilepsy. This panel involves the analysis of at least 24 genes that are associated with epilepsy and may help in diagnosing the condition or identifying a genetic predisposition to it. The test is performed on a specimen, such as blood, and evaluates the genetic sequences of the specified genes to provide valuable insights into the patient’s condition.

2. Official Description

The official description of CPT code 81419 is: ‘Epilepsy genomic sequence analysis panel, must include analyses for ALDH7A1, CACNA1A, CDKL5, CHD2, GABRG2, GRIN2A, KCNQ2, MECP2, PCDH19, POLG, PRRT2, SCN1A, SCN1B, SCN2A, SCN8A, SLC2A1, SLC9A6, STXBP1, SYNGAP1, TCF4, TPP1, TSC1, TSC2, and ZEB2.’

3. Procedure

1. The lab analyst performs the technical lab test by extracting nucleic acids from a specimen, such as blood.
2. The target genes, as specified in the code descriptor, are amplified using techniques like polymerase chain reaction (PCR).
3. A genomic sequence analysis is then conducted on the amplified genes using methods like next-generation sequencing (NGS).
4. The instrument used in the analysis compares the sequences obtained to a library of normal and variant gene sequences associated with epilepsy.
5. The findings are then interpreted by the lab analyst to provide insights into the patient’s condition and potential genetic predisposition to epilepsy.

4. Qualifying circumstances

CPT 81419 is used for patients who require a genomic sequence analysis panel to evaluate their genetic sequences for at least 24 genes associated with epilepsy. This test is typically ordered by clinicians to aid in the diagnosis and differentiation of various forms of epilepsy. It can also help identify gene mutations related to inherited epilepsy, enabling predictive testing for family members. The test is performed on germline or neoplastic specimens, such as blood, and requires the analysis of the specific genes listed in the code descriptor.

5. When to use CPT code 81419

CPT code 81419 should be used when a genomic sequence analysis panel is performed to evaluate the genetic sequences of at least 24 genes associated with epilepsy. This code is appropriate when the test is ordered to aid in the diagnosis, differentiation, or identification of genetic predisposition to epilepsy. It is important to note that individual gene codes should not be separately reported in addition to CPT code 81419.

6. Documentation requirements

To support a claim for CPT code 81419, the following documentation is required:

• Indication of the need for a genomic sequence analysis panel for epilepsy
• Specific genes included in the analysis
• Date of the test
• Details of the specimen used
• Methodology employed, such as next-generation sequencing (NGS)
• Interpretation of the findings
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT code 81419, ensure that the test is performed on at least 24 genes associated with epilepsy. It is important to note that individual gene codes should not be reported separately in addition to CPT code 81419. Additional tips for billing include considering separate codes for specimen collection, if applicable, and being aware of any specific payer requirements or guidelines for reporting this code.

8. Historical information

CPT code 81419 was added to the Current Procedural Terminology system on January 1, 2021. As of now, there have been no updates or changes to the code since its addition.

9. Examples

1. A patient undergoes a genomic sequence analysis panel for epilepsy, which includes the analysis of at least 24 genes associated with the condition. The test results help the clinician in diagnosing the specific form of epilepsy and determining the appropriate treatment plan.
2. Another patient with a family history of epilepsy undergoes the same genomic sequence analysis panel. The test identifies a gene mutation associated with inherited epilepsy, allowing for predictive testing of family members to assess their risk.
3. A child presents with recurrent seizures, and the clinician orders a genomic sequence analysis panel to evaluate the genetic sequences of the specified genes. The test results reveal a variant in one of the genes, providing valuable insights into the underlying cause of the seizures.
4. A patient with epilepsy that is difficult to manage undergoes the genomic sequence analysis panel. The test identifies multiple gene mutations associated with drug resistance, guiding the clinician in selecting alternative treatment options.
5. A newborn with seizures undergoes the genomic sequence analysis panel to determine the genetic basis of the condition. The test results reveal a mutation in one of the genes, aiding in the early diagnosis and management of the epilepsy.