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BETA v.3.0

2025 CPT code 81493

Coronary artery disease (CAD) risk score determined via gene expression profiling by real-time RT-PCR of 23 genes using whole peripheral blood.

This code should not be reported in conjunction with individual component tests. Procedures required prior to cell lysis, such as microdissection, can be reported separately.

Modifiers may be applicable in certain situations.

Medical necessity is determined by the patient's clinical presentation and risk factors for CAD. The test helps guide clinical decision-making regarding further diagnostic workup and preventive strategies.

Laboratory professionals perform the technical aspects of the test, including blood processing, RT-PCR, and data analysis. They also input patient data and generate the risk score report.

In simple words: A blood test that measures the activity of 23 genes to calculate your risk of developing heart disease.

This test analyzes 23 genes from whole peripheral blood using real-time reverse transcription polymerase chain reaction (RT-PCR) to generate a risk score for coronary artery disease (CAD). The process includes cell lysis, nucleic acid stabilization, extraction, amplification, hybridization, detection, and algorithmic analysis. Patient factors such as age and gender may also be incorporated into the algorithm.

Example 1: A patient presents with chest pain and other symptoms suggestive of CAD. This test is ordered to help assess their risk., An asymptomatic patient with multiple risk factors for CAD, such as family history, high cholesterol, and diabetes, undergoes this test to evaluate their likelihood of developing the disease., A patient with a history of CAD undergoes this test to assess their risk of future cardiac events.

Documentation should include the reason for testing, relevant patient history, and any associated symptoms. The report should include the risk score and interpretation.

** This code represents the Corus® CAD test. While the code describes the current process, it is important to note that medical billing practices and code usage can change. Always verify current coding guidelines and payer policies before billing.

** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.

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