How To Use CPT Code 81439

CPT 81439 describes the genomic sequence analysis panel for hereditary cardiomyopathy. 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 81439?

CPT 81439 can be used to describe the genomic sequence analysis panel performed to evaluate a patient’s specimen for genetic sequences of at least five cardiomyopathy-related genes. This test is specifically designed to identify hereditary cardiomyopathy conditions such as hypertrophic cardiomyopathy, dilated cardiomyopathy, or arrhythmogenic right ventricular cardiomyopathy.

2. Official Description

The official description of CPT code 81439 is: ‘Hereditary cardiomyopathy (eg, hypertrophic cardiomyopathy, dilated cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy), genomic sequence analysis panel, must include sequencing of at least 5 cardiomyopathy-related genes (eg, DSG2, MYBPC3, MYH7, PKP2, TTN).’ It is important to note that CPT code 81439 should not be reported in conjunction with CPT codes 81413 and 81414 when performed on the same date of service. For genomic sequencing panel testing for cardiac ion channelopathies, refer to CPT codes 81413 and 81414.

3. Procedure

1. The lab analyst collects a patient specimen, such as blood, for the genomic sequence analysis panel.
2. Using specialized equipment, such as a next-generation gene sequencer, the lab analyst performs a genomic sequence analysis of at least five cardiomyopathy-related genes.
3. The instrument used in the procedure determines the order of nucleotides in DNA and reports the sequence as a string of letters, called a read.
4. The lab analyst compares the read to a reference genome of the same genes to identify any normal or variant gene sequences associated with certain conditions.

4. Qualifying circumstances

CPT 81439 is appropriate for patients who require evaluation for hereditary cardiomyopathy. This test is ordered by clinicians to identify any potential genetic component to cardiomyopathy, a chronic disease of the heart muscle. The results of this test can aid in diagnosis, individualized disease management, and modified surveillance and risk management for genetically susceptible individuals.

5. When to use CPT code 81439

CPT code 81439 should be used when performing a genomic sequence analysis panel for hereditary cardiomyopathy. It is important to note that this code should not be reported with CPT codes 81413 and 81414 when performed on the same date of service. Additionally, CPT code 81439 includes gene sequencing of each of the genes, so reporting an additional code for single gene analysis is not necessary.

6. Documentation requirements

To support a claim for CPT 81439, the following documentation is required:

• Patient’s diagnosis and indication for the genomic sequence analysis panel
• Specific genes included in the panel
• Date of the test
• Start and end time of the procedure
• Results of the genomic sequence analysis
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 81439, ensure that the test is performed for hereditary cardiomyopathy and includes sequencing of at least five cardiomyopathy-related genes. It is important to note that CPT code 81439 should not be reported with CPT codes 81413 and 81414 when performed on the same date of service. Some payers may also separately reimburse for specimen collection using a code such as 36415.

8. Historical information

CPT 81439 was added to the Current Procedural Terminology system on January 1, 2017. The code was later changed on January 1, 2018, with an updated description for clarity.

9. Examples

1. A patient with a family history of hypertrophic cardiomyopathy undergoes a genomic sequence analysis panel to identify any genetic variants associated with the condition.
2. A newborn with symptoms of dilated cardiomyopathy undergoes a genomic sequence analysis panel to determine if there are any genetic factors contributing to the condition.
3. A patient with arrhythmogenic right ventricular cardiomyopathy undergoes a genomic sequence analysis panel to identify any genetic mutations that may be responsible for the condition.
4. A family with a history of cardiomyopathy undergoes a genomic sequence analysis panel to assess their risk of developing the condition.
5. A patient with an unexplained cardiomyopathy undergoes a genomic sequence analysis panel to identify any genetic abnormalities that may be contributing to the condition.
6. A patient with a known genetic mutation associated with cardiomyopathy undergoes a genomic sequence analysis panel to assess the impact of the mutation on their condition.
7. A patient with a suspected hereditary cardiomyopathy undergoes a genomic sequence analysis panel to confirm the diagnosis and guide treatment decisions.
8. A patient with a family history of sudden cardiac death undergoes a genomic sequence analysis panel to identify any genetic factors that may increase their risk.
9. A patient with a history of dilated cardiomyopathy undergoes a genomic sequence analysis panel to identify any genetic variants that may be contributing to their condition.
10. A patient with a family history of arrhythmogenic right ventricular cardiomyopathy undergoes a genomic sequence analysis panel to assess their risk of developing the condition.