How To Use CPT Code 81541

CPT 81541 describes the mRNA gene expression profiling for prostate cancer using real-time RT-PCR of 46 genes. 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 81541?

CPT 81541 can be used to describe the mRNA gene expression profiling for prostate cancer using real-time RT-PCR of 46 genes. This code is used when the lab analyst performs the technical lab tests and carries out an algorithmic analysis using patient data and the lab test results to report a mortality risk score or predict post-prostatectomy risk of recurrence.

2. Official Description

The official description of CPT code 81541 is: ‘Oncology (prostate), mRNA gene expression profiling by real-time RT-PCR of 46 genes (31 content and 15 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a disease-specific mortality risk score.’

3. Procedure

1. The lab analyst performs the technical lab tests using formalin-fixed paraffin-embedded tissue to measure the activity of 46 genes using real-time polymerase chain reaction (RT-PCR).
2. The lab analyst inputs the test results and patient information into a computer program to analyze the data using a specific algorithm.
3. The algorithmic analysis produces a disease-specific mortality risk score or a score for post-prostatectomy risk of recurrence.

4. Qualifying circumstances

CPT 81541 is used for patients with a positive prostate cancer biopsy who require mRNA gene expression profiling. This test helps determine the aggressiveness of existing prostate cancer or assess the risk of post-prostatectomy recurrence within 10 years. It aids clinicians in making treatment and monitoring decisions.

5. When to use CPT code 81541

CPT code 81541 should be used when performing mRNA gene expression profiling for prostate cancer using real-time RT-PCR of 46 genes. It is appropriate for patients with a positive prostate cancer biopsy who require a mortality risk score or risk assessment for post-prostatectomy recurrence.

6. Documentation requirements

To support a claim for CPT 81541, the documentation should include:

• Patient information and relevant clinical data
• Details of the technical lab tests performed
• Results of the gene expression profiling using real-time RT-PCR
• Algorithmic analysis and the reported mortality risk score or risk assessment

7. Billing guidelines

When billing for CPT 81541, ensure that the technical lab tests and algorithmic analysis are performed. Do not separately report the technical lab tests included in the MAAA code. Use the unlisted MAAA code, 81599, only if there is no Category I or administrative code available for the specific MAAA test.

8. Historical information

CPT 81541 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 lab analyst performs mRNA gene expression profiling for prostate cancer using real-time RT-PCR of 46 genes and reports a mortality risk score for a patient with a positive biopsy.
2. A patient with prostate cancer undergoes mRNA gene expression profiling for risk assessment of post-prostatectomy recurrence within 10 years.
3. A clinician orders mRNA gene expression profiling for prostate cancer to determine the aggressiveness of the existing cancer and make treatment decisions.
4. A lab analyst performs real-time RT-PCR of 46 genes for a patient with prostate cancer and reports a mortality risk score to aid in monitoring the disease.
5. A patient with prostate cancer undergoes mRNA gene expression profiling to assess the risk of recurrence after prostatectomy and guide further treatment options.
6. A lab analyst analyzes the gene expression data of a patient with prostate cancer using real-time RT-PCR of 46 genes and reports a mortality risk score for personalized treatment planning.
7. A clinician orders mRNA gene expression profiling for a patient with prostate cancer to determine the need for aggressive treatment or active surveillance.
8. A lab analyst performs real-time RT-PCR of 46 genes for a patient with prostate cancer and provides a risk assessment for post-prostatectomy recurrence.
9. A patient with prostate cancer undergoes mRNA gene expression profiling to evaluate the likelihood of disease progression and guide treatment decisions.
10. A lab analyst analyzes the gene expression data of a patient with prostate cancer using real-time RT-PCR of 46 genes and reports a mortality risk score to aid in prognosis and treatment planning.