2025 CPT code 81200
(Active) Effective Date: N/A Revision Date: N/A Laboratory - Molecular Pathology Procedures Pathology and Laboratory Procedures Feed
Analysis of the ASPA gene for common variants (e.g., E285A, Y231X).
Modifier 26 may be appended if only interpretation and reporting are performed by a physician.Other modifiers may apply based on specific circumstances (e.g., 59 for distinct procedural service, 90 for outside laboratory, 91 for repeat testing).
Medical necessity for this test is established by the presence of symptoms or family history suggestive of Canavan disease, or as part of newborn screening or carrier testing. Payer-specific guidelines may apply.Documentation supporting the clinical indication for testing is crucial.
The clinical responsibility lies with the laboratory analyst who performs the technical aspects of the test, including nucleic acid extraction, amplification, and detection. Physician interpretation, if separately ordered, is reported with a modifier (e.g., 26) and a separate code (e.g., G0452).
In simple words: This lab test checks for common changes in the ASPA gene, which can cause Canavan disease. The test involves several steps to find these gene changes. The results show if the gene is changed or not.
This CPT code encompasses the analysis of the aspartoacylase (ASPA) gene to detect common variants, such as E285A and Y231X.The procedure includes all analytical steps: nucleic acid extraction (e.g., cell lysis, digestion), amplification, and detection of target gene variants.While the test typically includes all listed variants, it may also identify other unlisted variants.The results are qualitative unless otherwise specified.
Example 1: A patient presents with symptoms suggestive of Canavan disease.The physician orders the 81200 test to identify common ASPA gene variants to confirm or rule out the diagnosis., A newborn screening reveals a potential ASPA gene abnormality.The 81200 test is ordered for confirmatory testing and to determine the specific variant(s) present., A family history of Canavan disease prompts genetic testing.The 81200 test is ordered for at-risk family members to assess their carrier status or to identify disease-causing variants.
Detailed patient history, including symptoms, family history of Canavan disease (if applicable), and clinical indication for testing.Lab report indicating the specific ASPA gene variants identified (if any) and interpretation by a qualified healthcare professional if applicable.
** This code is for the analysis of common variants.Testing for additional uncommon variants should be included and not billed separately. Full gene sequencing should not be reported using this code unless explicitly stated in the code description.Always refer to the most up-to-date CPT codebook for accurate coding guidelines.
- Revenue Code: Z2
- RVU: Information not available in provided text.
- Global Days: Information not available in provided text.
- Payment Status: Active
- Modifier TC rule: Information not available in provided text.The technical component is typically included in 81200.
- Fee Schedule: Information not available in provided text.
- Specialties:Genetic counseling, neurology, medical genetics, neonatology.
- Place of Service:Office, Hospital (Inpatient or Outpatient), Laboratory