2025 CPT code 81247

G6PD (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; common variant(s) (eg, A, A-)

Code 81247 is specific to the analysis of common G6PD variants. If known familial variants are being analyzed, use 81248. For a full gene sequence analysis of G6PD, use 81249. Procedures performed prior to cell lysis, such as microdissection (88380/88381) should be reported separately. Modifier 26 can be appended if only the professional interpretation and report are performed by a physician.

Modifier 26 may be appended to 81247 if a physician or other qualified healthcare professional performs only the professional component (interpretation and report) of the test.

Medical necessity for 81247 is established by the presence of clinical findings or risk factors suggesting G6PD deficiency. This can include symptoms such as hemolytic anemia, jaundice (particularly in newborns), or family history of the condition.Testing is also medically necessary prior to the administration of certain medications known to trigger hemolytic anemia in individuals with G6PD deficiency.

The lab analyst performs the technical aspects of this test, including extracting nucleic acids (DNA/RNA), amplifying the G6PD gene regions of interest, and detecting the presence of specific variants.

In simple words: This test looks for common changes in the G6PD gene, which can cause problems like anemia and jaundice.It's a detailed look at specific parts of the gene, but not the entire gene sequence.

This code represents the laboratory analysis of the G6PD gene for common variants, such as A-, associated with conditions like hemolytic anemia and jaundice. The procedure includes all analytical steps involved in testing for these variants, from nucleic acid extraction and amplification to detection.It's important to note that this code specifically targets common variants, and not a full gene sequence analysis, unless explicitly stated in the code descriptor. Additional variants tested beyond the common ones included in the analysis are not reported separately.

Example 1: A male newborn of Asian descent presents with unexplained jaundice within the first 24 hours of life. 81247 is ordered to assess for G6PD deficiency., A patient is scheduled to begin treatment with primaquine for malaria. 81247 is ordered prior to starting the medication to check for G6PD deficiency, which could lead to drug-induced hemolytic anemia., A woman whose brother has G6PD deficiency wants to know if she is a carrier. 81247 may be ordered to assess her carrier status, as G6PD deficiency is an X-linked trait.

Documentation should support the medical necessity of the G6PD gene analysis, specifying the suspected diagnosis or clinical indication for the test (e.g., hemolytic anemia, jaundice, pre-medication screening). Family history of G6PD deficiency should also be noted, if applicable.

  • Payment Status: unknown
  • Specialties:Hematology, Genetics, Pathology, Internal Medicine, Pediatrics
  • Place of Service:Independent Laboratory, Hospital Outpatient, Office
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