2025 CPT code 81462
(Active) Effective Date: N/A Revision Date: N/A Laboratory - Genomic Sequencing Procedures and Other Molecular Multianalyte Assays Pathology and Laboratory Feed
Genomic sequence analysis panel for solid organ neoplasms using cell-free nucleic acid (e.g., plasma) to detect sequence variants, copy number variants, and rearrangements.
Modifiers may be applicable depending on the specific circumstances of the service.Consult the CPT manual and payer guidelines for appropriate modifier usage.
Medical necessity is established by the presence of a suspected or diagnosed solid organ neoplasm and the need to obtain genetic information from circulating tumor DNA (ctDNA) when tissue biopsy is difficult, impossible, or impractical to obtain, or when faster results are needed to guide treatment decisions.
The clinical responsibility lies with the laboratory performing the test, encompassing specimen processing, nucleic acid extraction and amplification, NGS sequencing, bioinformatic analysis, and result reporting.The ordering physician is responsible for clinical interpretation and treatment decisions based on the results.
In simple words: This blood test analyzes DNA fragments circulating in the blood to find genetic changes related to solid organ cancers.It helps doctors diagnose and plan cancer treatment.
This CPT code, 81462, represents a genomic sequence analysis panel performed on a cell-free nucleic acid (e.g., plasma) specimen from a patient with a suspected or diagnosed solid organ neoplasm.The analysis evaluates for sequence variants, copy number variants, and rearrangements.The test utilizes methods such as next-generation sequencing (NGS) to analyze DNA or combined DNA and RNA. Results help inform diagnosis and treatment strategies.
Example 1: A 60-year-old male patient presents with symptoms suggestive of colorectal cancer.Due to difficulties obtaining a tissue biopsy, a liquid biopsy using 81462 is ordered to detect circulating tumor DNA and assess for actionable mutations to guide treatment decisions., A 55-year-old female with lung cancer undergoes surgery.Post-surgery, a liquid biopsy using 81462 is performed to monitor for minimal residual disease and detect any potential recurrence., A 45-year-old patient with metastatic pancreatic cancer is experiencing disease progression. A liquid biopsy using 81462 is ordered to assess the tumor's genomic profile for potential treatment options, including targeted therapies or immunotherapy.
Patient demographics, clinical history (including cancer diagnosis, stage, and treatment history), indication for testing, specimen collection details (date, time, collection method), test results, and interpretation.
** This code is part of a family of codes (81462-81464) designed to cover genomic sequencing from liquid biopsies.The choice of specific code within the family depends on the types of genetic alterations being assessed (sequence variants, copy number variants, rearrangements, MSI, and TMB).
- Revenue Code: T1G (LAB TESTS - OTHER)
- RVU: Information on RVUs is not provided in the source data.Consult the AMA CPT codebook or your specific payer's guidelines for this information.
- Global Days : The global period is not specified in the source data.Specific payer guidelines should be consulted for reimbursement rules.
- Payment Status: Active
- Modifier TC rule: Not applicable
- Fee Schedule : The source data does not provide historical fee schedules.Consult publicly available fee schedules and your payer's guidelines.
- Specialties:Oncology, Pathology, Medical Genetics
- Place of Service:Hospital (Inpatient or Outpatient), Ambulatory Surgical Center, Physician Office, Laboratory