2025 CPT code 81241

F5 (coagulation Factor V) (eg, hereditary hypercoagulability) gene analysis, Leiden variant

Prior procedures like microdissection (88380/88381) or tissue selection (88363) should be reported separately. Physician interpretation with a report can be billed with modifier 26.Full gene sequencing should not be reported with this code unless specifically indicated in the descriptor.Refer to CPT guidelines for Molecular Pathology Procedures for additional information.

Modifier 26 can be used if only the professional component (interpretation and report) is performed by the physician.

Medical necessity for this test is established when there is clinical suspicion of Factor V Leiden thrombophilia, such as a personal or family history of venous thromboembolism, recurrent pregnancy loss, or other thrombotic events. The test helps guide treatment decisions, including anticoagulation therapy.

The lab analyst is responsible for performing all technical aspects of the test, including cell lysis, nucleic acid stabilization, extraction, digestion, amplification, and detection.Physician interpretation and reporting can be separately billed (eg. G0452 with modifier 26).

In simple words: This lab test looks for a specific change in your F5 gene, called the Leiden variant. The F5 gene helps control blood clotting. If you have the Leiden variant, you may be more likely to develop blood clots. The test helps doctors diagnose a condition called Factor V Leiden thrombophilia, which can cause excessive clotting.

This code represents a gene-specific molecular pathology procedure for the analysis of the F5 gene (coagulation Factor V) to detect the Leiden variant.This test aids in diagnosing Factor V Leiden thrombophilia, a hypercoagulability condition associated with slowed inactivation of Factor V Leiden protein, leading to excessive blood clotting and increased risk of conditions like deep vein thrombosis and pulmonary embolism. The Leiden mutation interferes with the normal function of activated protein C (APC), which typically inactivates Factor V and regulates the clotting process. The test involves technical steps from nucleic acid extraction through amplification and detection, and includes all analytical services.

Example 1: A 30-year-old woman with a family history of blood clots and recurrent miscarriages undergoes testing for Factor V Leiden., A 55-year-old man presents with deep vein thrombosis.Factor V Leiden testing is ordered to assess his risk factors., A 25-year-old woman experiences a pulmonary embolism after a long flight.Genetic testing, including analysis of the F5 gene for the Leiden variant, is performed to identify potential underlying causes.

Documentation should include relevant medical history, family history of thrombotic events, clinical findings, and the reason for testing (e.g., diagnosis of thrombophilia, risk assessment). The interpretation and report, if performed separately, should also be documented.

  • Specialties:Hematology, Pathology, Genetics, Obstetrics and Gynecology (in the context of recurrent pregnancy loss)
  • Place of Service:Independent Laboratory, Hospital Outpatient, Office
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