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2025 CPT code 81445

Genomic sequence analysis panel for solid organ neoplasm; 5-50 genes; DNA or combined DNA/RNA analysis.

Follow CPT guidelines for genomic sequencing procedures.Ensure that the reporting code accurately reflects the components of the test performed.

Modifiers may be applicable depending on the circumstances of service delivery. Consult the CPT manual for guidance on appropriate modifier use.

Medical necessity for this test is determined by the clinical suspicion of a solid organ neoplasm and the need for comprehensive genomic profiling to guide personalized cancer treatment strategies.The physician's documentation should justify the test based on the patient's clinical presentation and need for targeted therapy selection or participation in clinical trials.

A laboratory analyst performs this test. The physician is responsible for ordering the test based on clinical indications, interpreting results, and integrating them into the patient's overall care plan.

IMPORTANT:For >50 genes, use 81455.For hematolymphoid neoplasms, use 81450. For RNA analysis only, use 81449. Codes 81457-81459 and 81462-81464 are used for tests including cell-free nucleic acid, MSI, or TMB.

In simple words: This lab test analyzes a sample of tumor tissue to check for genetic changes in 5 to 50 genes linked to solid organ cancers. It looks for specific gene alterations, changes in the number of gene copies, and structural rearrangements within the genes.

This CPT code encompasses a genomic sequence analysis panel designed to evaluate a patient specimen for targeted genetic sequences (5-50 genes) associated with solid organ cancers.The analysis includes interrogation for sequence variants, copy number variants, and rearrangements (if performed).The procedure utilizes DNA analysis, or a combined DNA and RNA analysis approach.

Example 1: A patient presents with a suspicious lung nodule. A biopsy is taken, and the tissue is sent to the lab for genomic sequencing using code 81445 to identify potential driver mutations and inform treatment decisions., A patient with colon cancer undergoes surgery.The resected tumor specimen is sent for comprehensive genomic profiling using code 81445 to detect actionable mutations and assess for potential resistance mechanisms., A patient with metastatic breast cancer is enrolled in a clinical trial requiring genomic sequencing analysis to determine eligibility. The lab uses code 81445 to analyze a tumor biopsy, looking at multiple genes related to response to targeted therapies.

Complete patient demographics, a detailed clinical history, information regarding the source of the specimen (e.g., biopsy, surgery), date of collection, and the specific genes tested. Pathology reports correlating the genomic findings to the patient's clinical presentation are essential.

** This code is intended for use with solid organ neoplasms.Appropriate coding for hematolymphoid neoplasms utilizes different codes within the 81400 series.The number of genes analyzed is critical in determining the appropriate code. Refer to CPT guidelines for detailed instructions and coding scenarios.

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