2025 CPT code 81400

Molecular pathology procedure, Level 1;identifies single germline variants using techniques like restriction enzyme digestion or melt curve analysis.

Follow CPT guidelines for molecular pathology procedures. Ensure the specific gene and variant tested are included in the code description.If testing for additional variants is performed, they are included in the procedure and are not reported separately.

Modifier 26 may be appended if only interpretation and report are performed by a physician.

Medical necessity is established based on clinical suspicion of a specific genetic disorder based on symptoms or family history. Supporting documentation such as relevant laboratory findings or imaging studies should be provided.

The lab analyst performs all technical aspects, including nucleic acid extraction, amplification, and variant detection. Physician interpretation may be separately reported using modifier 26.

IMPORTANT If the analyte tested is not listed under 81400 or a Tier 1 code, use unlisted molecular pathology procedure code 81479.

In simple words: This lab test looks for a single change in a gene passed down from parents.It uses special techniques to find this change in your DNA.

This CPT code 81400 represents a Level 1 molecular pathology procedure. It encompasses the identification of a single germline variant, which can be achieved through methods such as restriction enzyme digestion or melt curve analysis. The procedure includes all analytical steps, from nucleic acid extraction and amplification to variant detection.Specific analytes tested are listed within the code description, and should be reported accordingly. If an analyte is not specified or falls outside the defined scope, use code 81479.

Example 1: A patient presents with symptoms suggestive of medium-chain acyl-CoA dehydrogenase deficiency (MCADD).Testing for the ACADM K304E variant using 81400 is ordered to confirm or refute the diagnosis., Genetic testing is performed on a newborn suspected of having maple syrup urine disease (MSUD). Analysis using 81400 targets the BCKDHA Y438N variant., A patient with a family history of hereditary hypercoagulability undergoes testing for variants in the F2 gene. The analysis using 81400 focuses on the F2 1199G>A variant.

Detailed patient history, including family history, symptoms, and relevant clinical information.Lab reports specifying the specific analyte(s) tested and results of the analysis.

** Code 81400 is a Tier 2 code used for molecular pathology procedures not listed in the Tier 1 codes (81161, 81200-81383). It represents lower-volume procedures compared to Tier 1 codes and is arranged by levels of technical resources and interpretive work.

  • Payment Status: Active
  • Specialties:Medical Genetics, Clinical Genetics, Biochemical Genetics
  • Place of Service:Laboratory
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