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2025 CPT code 81248

Analysis of known familial variants in the glucose-6-phosphate dehydrogenase (G6PD) gene.

Follow CPT guidelines for molecular pathology procedures.Consider additional codes for pre-analytic procedures if performed.

Modifiers may apply depending on the circumstances (e.g., modifier 26 for physician interpretation and report, modifiers for place of service).

Medical necessity for this test is established by the patient's clinical presentation suggesting a G6PD deficiency (e.g., unexplained hemolytic anemia, jaundice) or family history of G6PD deficiency.Pre-emptive testing may also be justified before initiating medications known to induce hemolytic anemia in G6PD deficient individuals.

The clinical responsibility lies with the laboratory analyst who performs all technical aspects of the test. The ordering physician is responsible for medical decision making based on the results.

IMPORTANT:Distinguish from CPT code 81247 (G6PD common variant testing) and CPT code 81249 (G6PD full gene analysis).Prior procedures like tissue selection (88363), microdissection (88380), or special macroscopic dissection (88387 or 88388) may be reported separately when performed.Physician interpretation and report can be separately reported with CPT code G0452 with modifier 26.

In simple words: This lab test checks for specific, known inherited variations in the G6PD gene.It helps doctors understand if a patient has a G6PD enzyme deficiency, which can cause problems with certain medications or lead to jaundice.

This CPT code encompasses the technical component of analyzing known familial variants within the glucose-6-phosphate dehydrogenase (G6PD) gene.The procedure includes nucleic acid extraction (e.g., digestion and cell lysis), amplification to increase the quantity of the target nucleic acid, and detection using methods such as nucleic acid probes.The analysis is qualitative, and all listed variants are typically tested, though the list is not exclusive.Prior procedures like microdissection (CPT codes 88380 and 88381) are reported separately.

Example 1: A patient is considering starting a medication known to induce hemolytic anemia in individuals with G6PD deficiency.This test is ordered to assess the patient's risk before initiating treatment., A newborn presents with unexplained jaundice.This test is ordered to rule out G6PD deficiency as a potential cause., A female family member of an individual with known G6PD deficiency undergoes testing to determine her carrier status.

Documentation should include the patient's clinical presentation, reason for ordering the test, and any relevant family history.The lab report should include the specific variants tested, the results of the analysis, and any interpretations.

** The specific familial variants analyzed should be documented in the lab report.Payers may have specific requirements for reimbursement.

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

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