2025 CPT code 81458
Genomic sequence analysis panel for solid organ neoplasm evaluating DNA sequence variants, copy number variants, and microsatellite instability (MSI).
Modifiers may be applicable depending on the circumstances of the testing (e.g., Modifier 90 for reference lab services).
Medical necessity is established when the test is ordered to guide treatment decisions for solid organ neoplasms based on established guidelines (e.g., NCCN).
The laboratory analyst performs this test using a patient specimen, such as tumor tissue. They extract DNA, amplify target regions, and analyze it using next-generation sequencing (NGS) to identify sequence variants, copy number variants, and MSI. The clinician uses these results for diagnosis and treatment planning.
In simple words: This test analyzes a tumor sample to look for specific DNA changes that can affect cancer diagnosis and treatment. It checks for typos in the DNA code (sequence variants), extra or missing pieces of DNA (copy number variants), and a feature called MSI, which shows how likely the tumor cells are to develop more changes in their DNA and may help with treatment choices.
This genomic sequencing procedure analyzes a solid organ neoplasm specimen for DNA sequence variants, copy number variants, and microsatellite instability (MSI). It helps guide diagnosis and treatment strategies for solid organ cancers.
Example 1: A patient with newly diagnosed lung cancer needs molecular testing to guide targeted therapy. Code 81458 is used as the tumor specimen is analyzed by NGS to identify actionable genetic alterations, copy number changes, and assess MSI status to personalize treatment and predict response to immunotherapy., A patient with colorectal cancer undergoes surgery, and the pathologist orders this test on the tumor tissue. The results reveal the presence of specific mutations, copy number variations, and stable microsatellites, all informing prognosis and potential treatment options., A patient with a suspected hereditary cancer syndrome undergoes testing. This code is used to analyze a tumor biopsy for genomic alterations, which, in conjunction with germline testing, can confirm or rule out the presence of a hereditary predisposition.
Documentation must include the type of specimen, the specific genes analyzed, the methodology (e.g., NGS), and the results, including the detected sequence variants, copy number changes, and MSI status.
- Specialties:Oncology, Pathology, Genetics, and other specialties involved in the diagnosis and treatment of solid organ neoplasms.
- Place of Service:Independent Laboratory, Hospital Inpatient/Outpatient