2025 CPT code 81364
Effective Date: N/A Pathology and Laboratory Procedures - Molecular Pathology Procedures Feed
HBB (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); full gene sequence
Modifier 26 can be appended to 81364 when only the interpretation and report are performed by the physician.
Medical necessity for 81364 is established when there is clinical suspicion of a condition caused by a mutation in the HBB gene, such as sickle cell disease, beta-thalassemia, or other hemoglobinopathies. Genetic testing may be necessary to confirm the diagnosis, guide treatment decisions, or for prenatal screening.
The lab analyst performs all technical steps, from extracting the nucleic acids to amplifying and detecting the target genes using a specimen such as blood.
In simple words: This test analyzes the entire genetic code of the hemoglobin beta gene (HBB) to find changes. Hemoglobin is the protein in red blood cells that carries oxygen throughout the body. This test helps diagnose conditions like sickle cell anemia and beta thalassemia, which are caused by HBB gene mutations.
Full gene sequence analysis of the HBB gene is performed to detect variants indicative of germline or somatic conditions. This procedure includes all analytical services performed in the test (e.g., cell lysis, nucleic acid stabilization, extraction, digestion, amplification, and detection).
Example 1: A patient presents with symptoms suggestive of sickle cell anemia, such as pain crises and fatigue. 81364 is performed to analyze the HBB gene for mutations associated with sickle cell anemia., A pregnant woman has a family history of beta-thalassemia. 81364 is ordered to screen for potential beta-thalassemia mutations in the HBB gene., A patient with a suspected hemoglobinopathy undergoes 81364 testing to identify specific mutations in the HBB gene and confirm the diagnosis.
Documentation should include the patient's medical history, family history if relevant, signs and symptoms, and the reason for testing. The specific HBB variants being tested for should also be documented.
** For microbial identification, see 87149-87153 and 87471-87801, and 87900-87904. For in situ hybridization analyses, see 88271-88275 and 88365-88368.
- Specialties:Hematology, Genetics, Pathology
- Place of Service:Independent Laboratory, Hospital Outpatient