How To Use CPT Code 81470

CPT 81470 describes the genomic sequence analysis panel for X-linked intellectual disability (XLID) disorders. 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 81470?

CPT 81470 can be used to describe the genomic sequence analysis panel performed to evaluate a patient specimen for genetic sequences related to X-linked intellectual disability (XLID) disorders. This code requires the sequencing of at least 60 genes, including specific genes such as ARX, ATRX, CDKL5, FGD1, FMR1, HUWE1, IL1RAPL, KDM5C, L1CAM, MECP2, MED12, MID1, OCRL, RPS6KA3, and SLC16A2.

2. Official Description

The official description of CPT code 81470 is: ‘X-linked intellectual disability (XLID) (eg, syndromic and non-syndromic XLID); genomic sequence analysis panel, must include sequencing of at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, HUWE1, IL1RAPL, KDM5C, L1CAM, MECP2, MED12, MID1, OCRL, RPS6KA3, and SLC16A2.’

3. Procedure

1. The lab analyst performs a genomic sequence analysis panel using a patient specimen, such as blood.
2. The analysis involves sequencing at least 60 genes, including the specific genes listed in the code description.
3. A next-generation gene sequencer, an automated instrument, is used to determine the order of nucleotides in the DNA of the patient specimen.
4. The instrument generates a sequence, or read, which is compared to a reference genome of the same genes to identify any variations or abnormalities.
5. The analysis helps in the diagnosis of X-linked intellectual disability disorders, including syndromic and non-syndromic XLID.

4. Qualifying circumstances

CPT 81470 is used for patients who require evaluation for X-linked intellectual disability disorders. This analysis is ordered by clinicians for genetic counseling and to aid in the diagnosis of hereditary intellectual disabilities linked to the X chromosome. The analysis helps distinguish between various genetic disorders, including syndromic and non-syndromic XLID.

5. When to use CPT code 81470

CPT code 81470 should be used when performing a genomic sequence analysis panel for X-linked intellectual disability disorders. It is appropriate when sequencing at least 60 genes, including the specific genes listed in the code description. This code should not be used for other types of genetic testing or sequencing.

6. Documentation requirements

To support a claim for CPT 81470, the following documentation is required:

• Patient’s clinical indication for the genomic sequence analysis panel
• Specific genes included in the analysis, including the 60 genes required by the code
• Date and time of the analysis
• Results of the analysis, including any variations or abnormalities identified
• Signature of the lab analyst performing the analysis

7. Billing guidelines

When billing for CPT 81470, ensure that the analysis includes sequencing of at least 60 genes, including the specific genes listed in the code description. It is important to distinguish between CPT 81470 and CPT 81471, which involves duplication and deletion gene analysis. Report both codes if both procedures are performed. Additionally, consider using a separate code for specimen collection, such as CPT 36415.

8. Historical information

CPT 81470 was added to the Current Procedural Terminology system on January 1, 2015. There have been no updates to the code since its addition.

9. Examples

1. A lab analyst performs a genomic sequence analysis panel for a patient with suspected X-linked intellectual disability, sequencing at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, HUWE1, IL1RAPL, KDM5C, L1CAM, MECP2, MED12, MID1, OCRL, RPS6KA3, and SLC16A2.
2. A clinician orders a genomic sequence analysis panel for a patient with a family history of X-linked intellectual disability, including the sequencing of at least 60 genes, such as ARX, ATRX, CDKL5, FGD1, FMR1, HUWE1, IL1RAPL, KDM5C, L1CAM, MECP2, MED12, MID1, OCRL, RPS6KA3, and SLC16A2.
3. A lab analyst performs a genomic sequence analysis panel for a patient with suspected syndromic X-linked intellectual disability, analyzing at least 60 genes, including ARX, ATRX, CDKL5, FGD1, FMR1, HUWE1, IL1RAPL, KDM5C, L1CAM, MECP2, MED12, MID1, OCRL, RPS6KA3, and SLC16A2.
4. A clinician orders a genomic sequence analysis panel for a patient with non-syndromic X-linked intellectual disability, including the sequencing of at least 60 genes, such as ARX, ATRX, CDKL5, FGD1, FMR1, HUWE1, IL1RAPL, KDM5C, L1CAM, MECP2, MED12, MID1, OCRL, RPS6KA3, and SLC16A2.