2025 CPT code 81302

Analysis of the full sequence of the MECP2 gene.

Follow CPT guidelines for molecular pathology procedures, paying attention to gene-specific testing rules and the inclusion of all analytical services performed in the test.Modifier 26 may be appropriate when only interpretation is billed separately.

Modifiers such as 26 (professional component), 90 (reference lab), and GX (ABN) may be applicable depending on the circumstances. Consult payer-specific guidelines for modifier usage.

Medical necessity for this test is established based on the clinical presentation suggestive of Rett syndrome or other MECP2-related conditions. The test aids in early diagnosis, facilitating prompt management and family counseling.

The clinical responsibility lies with the laboratory analyst who performs all technical aspects of the test, from sample preparation to data analysis. A physician or qualified healthcare professional may interpret the results and generate a report, which may be billed separately (using modifier 26).

IMPORTANT For known familial MECP2 variants, use code 81303. For MECP2 duplication/deletion variants, use code 81304. For other unspecified MECP2 testing, 81479 may be considered.

In simple words: This lab test examines the entire MECP2 gene to check for any abnormalities.The MECP2 gene is involved in a rare neurological disorder called Rett syndrome, mainly affecting girls. This test helps diagnose Rett syndrome by analyzing the entire genetic code of the MECP2 gene.

This CPT code encompasses the complete sequencing analysis of the methyl CpG binding protein 2 (MECP2) gene.The procedure includes all analytical steps, from nucleic acid extraction (e.g., cell lysis, digestion) and amplification to detection of the target gene (e.g., using nucleic acid probes).This test analyzes the entire gene sequence, not just common variants. While not limited to any specific condition, it's frequently used in diagnosing Rett syndrome.

Example 1: A 2-year-old girl presents with developmental delays, hand-wringing, and impaired speech. The physician orders code 81302 to investigate suspected Rett syndrome., A female patient with a family history of Rett syndrome undergoes genetic testing using code 81302 for early detection and management of the disorder., A research study uses code 81302 to analyze the MECP2 gene in a cohort of patients with various neurological disorders to identify potential genetic correlations.

Detailed patient history including symptoms, family history, and physical examination findings. Complete laboratory requisition with specific instructions for the test.Properly labeled and collected patient sample (e.g., blood).Documentation of any pre-analytical processing steps like microdissection (if applicable).

** Always refer to the most up-to-date CPT codebook and payer guidelines for accurate coding and billing practices.This information is for guidance only and should not be considered a substitute for professional medical coding advice.

  • RVU: Information not available in provided sources.RVUs vary by payer and location.
  • Global Days : Not applicable. This is a laboratory test, not a surgical procedure.
  • Payment Status: Active
  • Modifier TC rule: A technical component (TC) modifier is not applicable since this code represents the complete laboratory procedure.
  • Fee Schedule : Fee schedules vary by payer and location. Consult payer-specific fee schedules for historical data.
  • Specialties:Medical Genetics, Neurology, Clinical Genetics, Pathology
  • Place of Service:Clinical Laboratory, Hospital Laboratory, Reference Laboratory
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