How To Use CPT Code 81542

CPT 81542 describes the mRNA gene expression profiling of 22 content genes in oncology (prostate) using formalin-fixed paraffin-embedded tissue. 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 81542?

CPT 81542 can be used to describe the mRNA gene expression profiling of 22 content genes in oncology (prostate) using formalin-fixed paraffin-embedded tissue. This code is used when the lab analyst performs the technical lab tests for mRNA gene expression profiling and carries out an algorithmic analysis using patient data and the lab-test results to report a risk score for prostate cancer metastasis.

2. Official Description

The official description of CPT code 81542 is: ‘Oncology (prostate), mRNA, microarray gene expression profiling of 22 content genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as metastasis risk score.’

3. Procedure

1. The lab analyst performs the technical lab tests for mRNA gene expression profiling of 22 content genes in oncology (prostate) using formalin-fixed paraffin-embedded tissue.
2. The lab analyst carries out an algorithmic analysis using patient data and the lab-test results.
3. The algorithmic analysis produces a risk score for prostate cancer metastasis.

4. Qualifying circumstances

Patients eligible to receive CPT 81542 services are those who require assessment of the risk of prostate cancer metastasis. The lab analyst performs the lab tests using formalin-fixed paraffin-embedded (FFPE) prostate tumor tissue to quantitatively measure the activity of 22 genes using real-time polymerase chain reaction (RT-PCR). The lab analyst inputs the test results along with patient information into a computer program to analyze the data using a specific algorithm and reports a risk score for prostate cancer metastasis.

5. When to use CPT code 81542

CPT code 81542 should be used when there is a need to assess the risk of prostate cancer metastasis using mRNA gene expression profiling of 22 content genes in oncology (prostate) with formalin-fixed paraffin-embedded tissue. This code is specific to the analysis of prostate cancer metastasis risk and should not be used for other purposes.

6. Documentation requirements

To support a claim for CPT 81542, the lab analyst must document the following information:

• Patient’s clinical information and reason for the test
• Details of the mRNA gene expression profiling test performed
• Results of the algorithmic analysis and the reported risk score for prostate cancer metastasis
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 81542, ensure that the lab analyst performs the technical lab tests for mRNA gene expression profiling of 22 content genes in oncology (prostate) using formalin-fixed paraffin-embedded tissue. The algorithmic analysis and reporting of the risk score should also be included. There are no specific guidelines regarding reporting CPT 81542 with other codes.

8. Historical information

CPT 81542 was added to the Current Procedural Terminology system on January 1, 2020. There have been no updates to the code since its addition.

9. Examples

1. A lab analyst performs mRNA gene expression profiling of 22 content genes in oncology (prostate) using formalin-fixed paraffin-embedded tissue and reports a risk score for prostate cancer metastasis.
2. A patient with prostate cancer undergoes mRNA gene expression profiling of 22 content genes in oncology (prostate) using formalin-fixed paraffin-embedded tissue, and the lab analyst reports a risk score for prostate cancer metastasis.
3. Using formalin-fixed paraffin-embedded tissue, a lab analyst performs mRNA gene expression profiling of 22 content genes in oncology (prostate) and provides a risk score for prostate cancer metastasis.
4. A risk score for prostate cancer metastasis is reported based on mRNA gene expression profiling of 22 content genes in oncology (prostate) using formalin-fixed paraffin-embedded tissue.
5. Formalin-fixed paraffin-embedded tissue is used for mRNA gene expression profiling of 22 content genes in oncology (prostate), and a risk score for prostate cancer metastasis is reported.
6. A lab analyst performs mRNA gene expression profiling of 22 content genes in oncology (prostate) using formalin-fixed paraffin-embedded tissue and provides a risk score for prostate cancer metastasis.
7. Molecular analysis of formalin-fixed paraffin-embedded tissue is conducted to assess the risk of prostate cancer metastasis based on mRNA gene expression profiling of 22 content genes in oncology (prostate).
8. A risk score for prostate cancer metastasis is determined through mRNA gene expression profiling of 22 content genes in oncology (prostate) using formalin-fixed paraffin-embedded tissue.
9. Using formalin-fixed paraffin-embedded tissue, a lab analyst performs mRNA gene expression profiling of 22 content genes in oncology (prostate) and reports a risk score for prostate cancer metastasis.
10. Molecular analysis of formalin-fixed paraffin-embedded tissue is conducted to evaluate the risk of prostate cancer metastasis based on mRNA gene expression profiling of 22 content genes in oncology (prostate).