How To Use CPT Code 81529

CPT 81529 describes the mRNA gene expression profiling for cutaneous melanoma using a multianalyte assay with algorithmic analysis. 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 81529?

CPT 81529 can be used to describe the mRNA gene expression profiling for cutaneous melanoma using a multianalyte assay with algorithmic analysis. This code is used when a lab analyst performs technical lab tests on a formalin-fixed paraffin-embedded (FFPE) tumor tissue specimen to evaluate the risk of tumor recurrence and metastasis in patients with cutaneous melanoma.

2. Official Description

The official description of CPT code 81529 is: ‘Oncology (cutaneous melanoma), mRNA, gene expression profiling by real-time RT-PCR of 31 genes (28 content and 3 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence risk, including likelihood of sentinel lymph node metastasis.’

3. Procedure

1. The lab analyst performs technical lab tests on a formalin-fixed paraffin-embedded (FFPE) tumor tissue specimen.
2. Nucleic acids are extracted from the tissue sample using methods such as cell lysis and digestion.
3. The lab stabilizes and increases the quantity of 28 target mRNA nucleic acid markers and 3 housekeeping markers.
4. A common procedure for the test uses reverse transcription PCR (RT-PCR) to create copy DNA (cDNA) for amplification and quantification using real-time PCR (qPCR).
5. The lab carries out an algorithmic analysis using patient data and the lab test results to report a risk score for cutaneous melanoma recurrence, including the likelihood of sentinel lymph node metastasis.

4. Qualifying circumstances

CPT 81529 is used for patients with cutaneous melanoma who require evaluation of the risk of tumor recurrence and metastasis. The test evaluates the mRNA gene expression profiling of 31 genes, including 28 content genes and 3 housekeeping genes. The analysis is performed on formalin-fixed paraffin-embedded (FFPE) tissue samples. The results provide a risk score for cutaneous melanoma recurrence, including the likelihood of sentinel lymph node metastasis.

5. When to use CPT code 81529

CPT code 81529 should be used when evaluating the risk of tumor recurrence and metastasis in patients with cutaneous melanoma. It is appropriate to bill this code when performing the mRNA gene expression profiling using a multianalyte assay with algorithmic analysis on formalin-fixed paraffin-embedded (FFPE) tissue samples. This code should not be used for testing other types of cancer or conditions.

6. Documentation requirements

To support a claim for CPT 81529, the following documentation is required:

• Documentation of the patient’s diagnosis of cutaneous melanoma
• Documentation of the need for mRNA gene expression profiling for risk assessment
• Details of the technical lab tests performed on the formalin-fixed paraffin-embedded (FFPE) tissue sample
• Documentation of the algorithmic analysis carried out using patient data and lab test results
• Report of the risk score for cutaneous melanoma recurrence, including the likelihood of sentinel lymph node metastasis
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 81529, ensure that the test is performed on formalin-fixed paraffin-embedded (FFPE) tissue samples for cutaneous melanoma. This code includes all technical lab tests, algorithmic analysis, and reporting of the results. Do not separately report any technical lab tests or other codes related to the test. Use the unlisted MAAA code, 81599, only if there is no specific Category I or administrative code available for the test.

8. Historical information

CPT 81529 was added to the Current Procedural Terminology system on January 1, 2021. There have been no updates to the code since its addition.

9. Examples

1. A patient with cutaneous melanoma undergoes mRNA gene expression profiling using CPT code 81529 to assess the risk of tumor recurrence and metastasis.
2. A lab analyst performs technical lab tests on a formalin-fixed paraffin-embedded (FFPE) tissue sample from a patient with cutaneous melanoma to evaluate the risk of tumor recurrence and metastasis using CPT code 81529.
3. CPT code 81529 is used to report the mRNA gene expression profiling for cutaneous melanoma in a patient, providing a risk score for recurrence and the likelihood of sentinel lymph node metastasis.
4. A physician orders the mRNA gene expression profiling for cutaneous melanoma using CPT code 81529 to guide further treatment decisions for a patient.
5. A lab reports the results of the mRNA gene expression profiling for cutaneous melanoma, including the risk score for recurrence and the likelihood of sentinel lymph node metastasis, using CPT code 81529.