2025 CPT code 81402

Molecular pathology procedure, level 3.This includes analysis of >10 single nucleotide polymorphisms (SNPs), 2-10 methylated variants, 2-10 somatic variants, immunoglobulin and T-cell receptor gene rearrangements, duplication/deletion variants of one exon, loss of heterozygosity (LOH), and uniparental disomy (UPD).

Tier 2 codes are used for molecular pathology procedures not found in Tier 1.The code should accurately reflect the specific analyte and level of resources used for testing. Modifier 26 should be appended if only the professional component (interpretation and report) is performed.

Medical necessity must be established by demonstrating that the test results will directly influence patient management decisions.

The laboratory professional performs all technical aspects of the procedure, including DNA/RNA extraction, amplification, and detection. The interpreting physician or other qualified healthcare professional analyzes the results and provides a report.

In simple words: This code covers a complex lab test that analyzes a patient's DNA or RNA to look for specific genetic changes.These changes can be small, like a single letter difference in the DNA code (SNP), or larger, like a missing or duplicated piece of DNA.The test can also be used to look for changes related to certain types of cancer or genetic disorders.

Molecular pathology procedure, Level 3 (eg, >10 SNPs, 2-10 methylated variants, or 2-10 somatic variants [typically using non-sequencing target variant analysis], immunoglobulin and T-cell receptor gene rearrangements, duplication/deletion variants of 1 exon, loss of heterozygosity [LOH], uniparental disomy [UPD])Chromosome 1p-/19q- (eg, glial tumors), deletion analysisChromosome 18q- (eg, D18S55, D18S58, D18S61, D18S64, and D18S69) (eg, colon cancer), allelic imbalance assessment (ie, loss of heterozygosity)COL1A1/PDGFB (t(17;22)) (eg, dermatofibrosarcoma protuberans), translocation analysis, multiple breakpoints, qualitative, and quantitative, if performedCYP21A2 (cytochrome P450, family 21, subfamily A, polypeptide 2) (eg, congenital adrenal hyperplasia, 21-hydroxylase deficiency), common variants (eg, IVS2-13G, P30L, I172N, exon 6 mutation cluster [I235N, V236E, M238K], V281L, L307FfsX6, Q318X, R356W, P453S, G110VfsX21, 30-kb deletion variant)ESR1/PGR (receptor 1/progesterone receptor) ratio (eg, breast cancer)MEFV (Mediterranean fever) (eg, familial Mediterranean fever), common variants (eg, E148Q, P369S, F479L, M680I, I692del, M694V, M694I, K695R, V726A, A744S, R761H)TRD@ (T cell antigen receptor, delta) (eg, leukemia and lymphoma), gene rearrangement analysis, evaluation to detect abnormal clonal populationUniparental disomy (UPD) (eg, Russell-Silver syndrome, Prader-Willi/Angelman syndrome), short tandem repeat (STR) analysis

Example 1: A patient with suspected glial tumor undergoes testing for Chromosome 1p/19q deletion analysis to aid in diagnosis and treatment planning., A patient with colon cancer has Chromosome 18q allelic imbalance assessment to determine the loss of heterozygosity and assess prognosis., A child with suspected congenital adrenal hyperplasia undergoes CYP21A2 gene analysis for common variants to confirm the diagnosis and guide management.

Documentation should include the specific gene(s) or genomic regions analyzed, the methodology used, the clinical indication for testing (e.g., diagnostic, prognostic, therapeutic), and the interpretation of the results.

** This code represents the technical component of the test.If the specimen requires preparation prior to cell lysis (e.g., microdissection), these services are reported separately. For microbial identification or in situ hybridization analyses, use the appropriate codes.

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