2025 CPT code 81450
(Revised) Effective Date: N/A Revision Date: N/A Pathology and Laboratory - Genomic Sequencing Procedures Pathology and Laboratory Procedures > Genomic Sequencing Procedures and Other Molecular Multianalyte Assays Feed
Genomic sequence analysis panel for hematolymphoid neoplasms; DNA or combined DNA/RNA analysis.
Modifiers may be applicable in certain circumstances (e.g., 59 for distinct procedural service, 90 or 91 for lab-related modifiers).Consult appropriate coding guidelines for modifier usage in relation to this code.
Medical necessity for 81450 is established when genomic sequencing is required to identify genetic alterations in hematolymphoid neoplasms to guide diagnostic and treatment decisions.This may include situations where targeted therapy is being considered or to monitor for minimal residual disease (MRD). The request should be supported by appropriate clinical indications, such as abnormal blood counts, clinical symptoms, or imaging findings suggestive of hematologic malignancy. Documentation should also detail the patient's clinical presentation that necessitates this advanced testing.
The clinical responsibility lies with the pathologist or clinical laboratory specialist who performs the genomic sequencing, analyzes the results, and provides a report to the ordering physician.The ordering physician is responsible for interpreting the report in the context of the patient's clinical presentation and making appropriate treatment decisions.
- Pathology and Laboratory Procedures > Genomic Sequencing Procedures and Other Molecular Multianalyte Assays
- 81450 is a parent code with 81451 as a child code.The code is part of a larger family of codes (81445, 81449, 81455-81464) related to genomic sequencing procedures for neoplasms.
In simple words: This lab test analyzes a blood or bone marrow sample to check for genetic changes in 5 to 50 genes linked to blood and lymph cancers. It looks for variations in gene sequences and copy numbers, helping doctors understand the cancer and plan treatment.
This CPT code encompasses a genomic sequence analysis panel designed to evaluate DNA, and potentially RNA, alterations within 5-50 genes implicated in hematolymphoid neoplasms (cancers of the blood and lymph system).The analysis includes interrogation for sequence variants, copy number variants, and rearrangements. Isoform or mRNA expression levels may also be evaluated if performed.
Example 1: A patient presents with suspected acute myeloid leukemia (AML). A bone marrow aspirate is sent for genomic sequencing using code 81450 to identify potential driver mutations for treatment selection., A patient with a history of chronic lymphocytic leukemia (CLL) experiences disease progression.A blood sample is sent for genomic sequencing (81450) to assess for the emergence of resistance mutations or new clonal populations., A patient with non-Hodgkin's lymphoma undergoes a lymph node biopsy. The biopsy tissue undergoes genomic sequencing using code 81450 to guide targeted therapy and predict prognosis.
* Patient demographics and relevant clinical history.* Specimen type (e.g., bone marrow aspirate, blood, lymph node biopsy).* Date and time of specimen collection.* Detailed description of the genomic sequencing method used.* List of genes analyzed.* Complete report including all identified variants, copy number variations, and rearrangements.* Any additional data such as isoform or mRNA expression levels.* Physician's order indicating medical necessity.
** This code's reimbursement may vary based on payer policies and may require prior authorization.It is essential to check with individual payers for specific coverage requirements and limitations.
- Payment Status: Active
- Modifier TC rule: A technical component (TC) modifier is not typically applicable to this code as it represents the professional interpretation of the genomic sequencing results.
- Specialties:Hematology, Oncology, Pathology
- Place of Service:Office, Hospital (Inpatient and Outpatient), Ambulatory Surgical Center, Clinical Laboratory