2025 CPT code 81449
(Revised) Effective Date: N/A Revision Date: N/A Molecular Pathology - Genomic Sequencing Procedures and Other Molecular Multianalyte Assays Pathology and Laboratory Feed
Genomic sequence analysis panel for RNA alterations in 5-50 genes impacting solid organ cancers.
Modifiers may apply depending on the circumstances of the service, such as multiple procedures or different locations of service.Refer to CPT guidelines for specific modifier usage and payer-specific rules.
Medical necessity is established when the results of the test are expected to significantly impact the management of a solid organ cancer. This includes situations where the results can guide treatment selection, monitor response, predict prognosis, or detect disease recurrence.
The clinical responsibility lies with the ordering physician who interprets the results to guide treatment decisions for solid organ cancers. The laboratory is responsible for performing the test accurately and providing the results.
In simple words: This lab test analyzes RNA from a tumor sample to look for changes in 5 to 50 genes linked to solid organ cancers. It helps doctors understand the cancer's genetic makeup and choose the best treatment.
This CPT code represents a genomic sequencing analysis panel targeting RNA alterations within 5 to 50 genes associated with solid organ neoplasms.The analysis involves nucleic acid extraction, RNA amplification (e.g., RT-PCR), and sequencing (e.g., NGS) to identify sequence variants and rearrangements. Bioinformatics is used to interpret results relative to known genetic changes in cancer development and progression. This test helps characterize genetic mutations and expression patterns to inform treatment decisions.
Example 1: A patient presents with a suspicious lung mass. A biopsy is performed, and RNA extracted from the tumor tissue undergoes sequencing using code 81449 to identify potential driver mutations and inform targeted therapy decisions., A patient with a history of colon cancer undergoes a follow-up examination.A genomic sequencing panel (81449) is ordered on a tumor sample to assess for recurrent mutations, response to previous treatments, and to detect potential resistance mechanisms., A patient diagnosed with metastatic renal cell carcinoma receives targeted therapy.After several months, the therapy's effectiveness decreases. Code 81449 testing is performed on a new tumor biopsy to identify acquired resistance mutations and adjust the treatment strategy.
Complete patient demographics, relevant clinical history (including prior treatments if any), details of the specimen source (tumor type, location, date of collection, method of acquisition), and the specific genes analyzed.The report should include the RNA sequencing results, interpretation of variants identified, and comparison to relevant databases.
** This code is specifically for RNA analysis of 5-50 genes.If DNA analysis is also performed, code 81445 may be more appropriate, depending on the specific methods used.Always refer to the latest CPT codebook and payer guidelines for accurate coding.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Specialties:Oncology, Pathology, Medical Oncology
- Place of Service:Hospital (Inpatient and Outpatient), Ambulatory Surgical Center, Independent Laboratory, Office