How To Use CPT Code 81535

CPT 81535 describes the process of live tumor cell culture and chemotherapeutic response evaluation for gynecologic oncology. 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 81535?

CPT 81535 is used to report the laboratory test that involves the culture of live tumor cells taken from female reproductive organs or tissues. The purpose of this test is to evaluate the tumor’s response to chemotherapy agents. The lab analyst performs cell staining with 4’–6–diamidino–2–phenylindole (DAPI) and examines the cell morphology to assess the tumor’s susceptibility to specific chemotherapy agents or combinations.

2. Official Description

The official description of CPT code 81535 is: ‘Oncology (gynecologic), live tumor cell culture and chemotherapeutic response by DAPI stain and morphology, predictive algorithm reported as a drug response score; first single drug or drug combination.’

3. Procedure

1. The lab analyst isolates and cultures live tumor cells from gynecological specimens.
2. The cells are then examined for cell morphology and stained with DAPI.
3. The lab analyst performs a predictive algorithm analysis to determine a drug response score for a single drug or drug combination.
4. The drug response score is reported to predict the tumor’s susceptibility to the chemotherapy agent(s).

4. Qualifying circumstances

CPT 81535 is used when live tumor cells from gynecological specimens are cultured and evaluated for their response to chemotherapy agents. This test is typically ordered to predict the expected response of the tumor to specific chemotherapy agents or combinations. It is important to note that this code is specific to gynecologic oncology.

5. When to use CPT code 81535

CPT code 81535 should be used when a laboratory test is performed to culture live tumor cells from gynecological specimens and evaluate their response to chemotherapy agents. This code is appropriate when assessing the tumor’s susceptibility to a single drug or drug combination. It is important to ensure that the test is specific to gynecologic oncology and not limited to testing for other conditions.

6. Documentation requirements

To support a claim for CPT 81535, the documentation should include:

• Patient information
• Details of the gynecological specimen used for the test
• Results of the cell culture and DAPI staining
• Drug response score obtained from the predictive algorithm analysis
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 81535, ensure that the test is specific to gynecologic oncology and involves the culture of live tumor cells. It is important to report this code for the first single drug or drug combination response score. If additional drug response scores are obtained, report them using CPT code 81536. It is also important to follow any specific billing guidelines provided by payers.

8. Historical information

CPT 81535 was added to the Current Procedural Terminology system on January 1, 2016. There have been no updates to the code since its addition.

9. Examples

1. A lab analyst cultures live tumor cells from a gynecological specimen and evaluates their response to a single chemotherapy drug.
2. A gynecologic oncologist orders the test to assess the tumor’s susceptibility to a specific drug combination.
3. A lab technician performs cell staining and morphology evaluation to determine the drug response score for a gynecologic tumor.
4. A predictive algorithm analysis is conducted to assess the tumor’s response to a single chemotherapy agent in gynecologic oncology.
5. A gynecologic oncology lab reports the drug response score for a specific drug combination based on live tumor cell culture and evaluation.
6. A pathologist examines the cell morphology and DAPI staining of live tumor cells from a gynecological specimen to predict the tumor’s response to chemotherapy.
7. A gynecologic oncology lab technician performs the test to evaluate the tumor’s susceptibility to a single chemotherapy drug.
8. A gynecologic oncologist orders the test to determine the drug response score for a specific drug combination in gynecologic oncology.
9. A lab analyst cultures live tumor cells from a gynecological specimen and performs a predictive algorithm analysis to assess the tumor’s response to a single drug.
10. A gynecologic oncology lab technician evaluates the drug response score for a specific drug combination based on live tumor cell culture and analysis.