How To Use CPT Code 81448

CPT 81448 describes the genomic sequence analysis panel for hereditary peripheral neuropathies. 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 81448?

CPT 81448 can be used to describe the genomic sequence analysis panel for hereditary peripheral neuropathies. This code is used when a lab analyst performs a genomic sequence analysis of at least five peripheral neuropathy-related genes using a patient specimen, such as blood. The purpose of this analysis is to evaluate the genetic sequences associated with conditions like Charcot-Marie-Tooth (CMT), hereditary motor and sensory neuropathy (HMSN), or hereditary spastic paraplegia (HSP).

2. Official Description

The official description of CPT code 81448 is: ‘Hereditary peripheral neuropathies (eg, Charcot-Marie-Tooth, spastic paraplegia), genomic sequence analysis panel, must include sequencing of at least 5 peripheral neuropathy-related genes (eg, BSCL2, GJB1, MFN2, MPZ, REEP1, SPAST, SPG11, SPTLC1)’

3. Procedure

1. The lab analyst collects a patient specimen, such as blood, for the genomic sequence analysis panel.
2. Using specialized equipment like a next-generation gene sequencer, the lab analyst performs a genomic sequence analysis of at least five peripheral neuropathy-related genes.
3. The instrument reports the sequence as a string of letters, which the analyst compares to a reference genome to identify any variations or mutations in the genes.
4. The analysis helps in establishing the diagnosis and genetic cause of hereditary peripheral neuropathies.

4. Qualifying circumstances

CPT 81448 is used for patients suspected of having hereditary peripheral neuropathies, such as Charcot-Marie-Tooth, spastic paraplegia, or other related conditions. The analysis must include sequencing of at least five peripheral neuropathy-related genes, such as BSCL2, GJB1, MFN2, MPZ, REEP1, SPAST, SPG11, and SPTLC1. Clinicians may order this test to aid in the diagnosis of these conditions when symptoms of various forms of hereditary peripheral neuropathies overlap, and a comprehensive genetic panel is needed to establish the diagnosis and genetic cause.

5. When to use CPT code 81448

CPT code 81448 should be used when a genomic sequence analysis panel is performed to evaluate the genetic sequences associated with hereditary peripheral neuropathies. It is appropriate to use this code when at least five peripheral neuropathy-related genes are sequenced using a patient specimen, such as blood. This code should not be reported separately if individual gene sequence analyses are already performed as part of the panel.

6. Documentation requirements

To support a claim for CPT 81448, the documentation should include:

• Patient’s symptoms and suspected diagnosis of hereditary peripheral neuropathies
• Details of the genomic sequence analysis panel performed, including the names of the genes sequenced
• Date and time of the analysis
• Results of the analysis, including any variations or mutations identified
• Signature of the lab analyst performing the analysis

7. Billing guidelines

When billing for CPT 81448, ensure that the analysis includes sequencing of at least five peripheral neuropathy-related genes. It is important to note that individual gene sequence analyses should not be reported separately if CPT 81448 is used for the comprehensive panel. Other codes, such as 36415 for specimen collection, may be reported separately. It is recommended to review the specific guidelines of payers to ensure accurate billing.

8. Historical information

CPT 81448 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 patient presents with symptoms of peripheral neuropathy, and the clinician orders a genomic sequence analysis panel to evaluate the genetic cause. The lab analyst performs the analysis, sequencing at least five peripheral neuropathy-related genes, and identifies a mutation in the MPZ gene.
2. A patient with a family history of Charcot-Marie-Tooth disease undergoes a genomic sequence analysis panel. The analysis includes sequencing of at least five peripheral neuropathy-related genes, and a variation is identified in the SPAST gene.
3. A patient presents with symptoms of hereditary spastic paraplegia, and the clinician orders a genomic sequence analysis panel. The analysis includes sequencing of at least five peripheral neuropathy-related genes, and a mutation is identified in the SPG11 gene.
4. A patient with suspected hereditary peripheral neuropathy undergoes a genomic sequence analysis panel. The analysis includes sequencing of at least five peripheral neuropathy-related genes, and a variation is identified in the BSCL2 gene.
5. A patient presents with symptoms of peripheral neuropathy, and the clinician orders a genomic sequence analysis panel. The analysis includes sequencing of at least five peripheral neuropathy-related genes, and a mutation is identified in the MFN2 gene.