2014 CPT Code Updates
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1 2014 CPT Code Updates This publication is a summary of The American Medical Association Current Procedural Terminology (CPT) codes published in ARUP's Laboratory Test Directory effective January 1, Tests not listed in this summary do not have CPT code changes at this time. The American Medical Association Current Procedural Terminology (CPT) codes published in ARUP s Laboratory Test Directory are provided for informational purposes only. The codes reflect our interpretation of CPT coding requirements based upon AMA guidelines published annually. CPT codes are provided only as guidance to assist clients with billing. ARUP strongly recommends that clients confirm CPT codes with their Medicare Administrative Contractor (MAC), as requirements may differ. CPT coding is the sole responsibility of the billing party. ARUP Laboratories assumes no responsibility for billing errors due to reliance on the CPT codes published. Please direct any questions Test Number Test Name 2014 CPT Code(s) PAX-FKHR Translocation by RT-PCR x SYT-SSX, t(x;18) Transloc by RT-PCR x KIT (D816V) Mutation by PCR JAK2 Gene, V617F Mutation, Quantitative NPM1 Mutation, PCR-Fragment Analysis Chorionic Villus, FISH x5; x5; IGHV Mutation Analysis by Sequencing KRAS Mutation Detection 88381; 81275; ERBB2 (HER2/neu) Amplification by PCR 88381; Hypersensitivity Pneumo Extended Panel x3; 86005; x7; x RUNX1-RUNX1T1 (AML1-ETO) t(8;21) RT-PCR MLL-AFF1 (MLL-AF4) t(4;11) RT-PCR Fragile X (FMR1) Diagnostic, Fetal 81243; 81244; HLA DRB3, 4, EWS-FLI1 Translocations by RT-PCR JAK2 Gene, V617F Mutation, Qualitative Ewing's Sarcoma ERG Transloc by RT-PCR HHT, Deletion and Duplication (ENG) HHT, Sequencing (ENG) HHT, Sequencing and Deletion/Duplication (ENG) (ENG) x2 Page 1 of 7
2 Juvenile Polyposis (SMAD4) Sequencing PCD (SLC22A5) Sequencing Microsatellite Instability by PCR 88381; BRAF with Reflex to MLH1 Methylation 88381; 81210; If reflexed, add Molar Pregnancy, 16 DNA Markers 81265; Alport Syndrome (COL4A5) Sequencing Allergen, Indoor x6; Allergen, Animal, Feather Mix Allergen, Inhalant/Food, Pro x28; Allergen, Animal, Dander, Feather x4; Allergen, Inhalant/Food, Western x23; Allergen, Inhalant, Environment Pro x9; Allergen, Inhalant/Food, Environment Pro x16; TCF3-PBX1 (E2A-PBX1) t(1;19) RT-PCR Allergen, Inhalant, Multiallergen Qual BCR-ABL1, t(9;22) Qual by RT-PCR 81206; IGH-CCND1 (BCL-1/JH) t(11;14) PCR T-Cell Clonality Screening by PCR IGH-BCL2 (BCL-2/JH) t(14;18) PCR BIRC2-MALT1(API2-MALT1) t(11;18) RT-PCR ETV6-RUNX1 (TEL-AML1) t(12;21) RT-PCR Culture, Neisseria gonorrhoeae 87081; Identification CPT codes may vary based on method Culture, Legionella species 87081; Identification CPT codes may vary based on method Culture, Bordetella pertussis 87081; Identification CPT codes may vary based on method Culture, Staphylococcus 87081; Identification CPT codes may vary based on method Culture, Streptococcus (Group A) 87081; Identification CPT codes may vary based on method Culture, Urine 87088; Identification CPT codes may vary based on method Culture, Brucella 87081; Identification CPT codes may vary based on method Culture, Corynebacterium diphtheriae 87081; Identification CPT codes may vary based on method Culture, Vanco-Resistant Enterococcus 87081; Identification CPT codes may vary based on method Leptin Quant by CIA Maternal Serum Screen AFP, hcg, Estriol (82105; 84702; 82677) or 81510* Maternal Serum Screen AFP, hcg, EST, INH (82105; 84702;82677;86336) or 81511* Ehlers-Danlos Syndrome Type VI Screen Page 2 of 7
3 Maternal Screening, INT-2 (82105; 84702;82677;86336) or 81511* Maternal Serum, First Trimester (84702;84163) or 81508* Maternal Screening, Sequential, Spec 1 (84702;84163) or 81508* Maternal Screening, Sequential, Spec 2 (82105; 84702;82677;86336) or 81511* Caffeine Level Gabapentin Level Doxepin and Metabolite, Serum or Plasma Lamotrigine Mycophenolic Acid Tiagabine, Serum or Plasma Everolimus CBFB-MYH11, inv(16) by RT-PCR Vascular Endothelial Growth Factor Lymphocyte Subset 6, with CD45RA/CD45RO 86355; 86357; 86359; 86360; x Lymphocyte Subset 7, Congenital Immun ; 86357; 86359; 86360; x Zonisamide Quantitative Keppra (Levetiracetam) Oxcarbazepine Metabolite Clozapine KRAS Mutation Detection with BRAF Reflex 88381; 81275; 81403; If reflexed, add JPS (SMAD4) Sequencing and Del/Dup 81405; JPS (SMAD4) Deletion/Duplication Pancreatitis (CFTR, PRSS1, SPINK1) Seq 81223; x Pancreatitis, Idiopathic (SPINK1) Seq Chimerism Post-Transplant, Sorted Cells 81268; If sorted cells is performed, BMT will be billed additionally using CPT 88184; Allergen, Inhalants, Pro x27; Mycophenolic Acid and Metabolite Page 3 of 7
4 Chromosome Analysis Rule Out Mosaicism 88230; 88263; Chromosome Analysis Chorionic Villus 88269; 88235; Chromosome FISH Prenatal x5; x5; Microarray Family Study by FISH 88230; 88271; 88273; Mismatch Repair IHC with Reflex to BRAF x4; if reflexed, add 88381, 81210; if further reflexed, add JAK2 Exon 12 Mutation Analysis by PCR Alport Syndrome (COL4A5) Del/Dup Alport Syndrome (COL4A5) Seq and Del/Dup 81407; KIT Mutations in AML EGFR by Pyrosequencing 88381; BRAF Codon 600 Mutation Detection 88381; MLH1 Methylation by PCR 88381; Gastrointestinal Stromal Tumor Mutation 88381; x KIT Mutations, Melanoma 88381; PML-RARA Translocation, t(15;17) Quant NRAS Mutation Detection, Pyrosequencing 88381; SEPT9 Methylated DNA Detection PAH (BMPR2) Deletion/Duplication PAH (BMPR2) Seq and Del/Dup 81405; PAH (BMPR2) Sequencing PTEN by IHC PCD (SLC22A5) Seq and Del/Dup 81405; CEBPA Mutation Detection PIK3CA Mutation Detection 88381; Estrogen Receptor by IHC Ki-67, MIB-1 by IHC p53 by IHC Progesterone Receptor by IHC IL28B-Associated Variants, 2 SNPs FibroSURE 0001M BCR-ABL1, T315I Mutation Detection, Quantitative CDKL5-Related Disorders (CDKL5) Del/Dup CDKL5-Related Disorders Seq and Del/Dup 81405; BCR-ABL1, Qualitative with Quant Reflex 81206; 81207; If reflexed, add or BCR-ABL1, Minor (p190), Quantitative BCR-ABL1, Major (p210), Quantitative Celiac HLA-DQA1*05, DQB1*02, DQB1*03: x Mismatch Repair IHC with Reflex to MLH x4; if reflexed, add 88381, VWD2A (VWF) Seq with Reflex to 9 exons 81403; If reflexed, add Page 4 of 7
5 VWD Type 2M (VWF) Sequencing Trichomonas vaginalis by TMA MPL codon 515 Mutation Detection, Quant WT1 Mutation Detection Mito Disorders (108 Nuc. Genes) Seq x9 (C10of2; COX6B1; CPT2; FXN; NDUFA1; NDUFS4; SCO2; SDHD; SLC25A5) x23 (ACADS; APTX; BCKDHA; BCSIL; COX10; COX15; DGUOK; FH; MPV17; NDUFS7; NDUFS8; NDUFV1; PDHB; PINK1; RRM2B; SCO1; SDHB; SDHC; SLC22A5; SLC25A20; SURF1; TK2; TYMP) x17 (ACADVL; ASS1; BCKHB; CPT1A; DBT; DLAT; DLD; HADHB; MCCC2; MFN2; NDUFS1; PC, PDHX, POLG, SDHA, SPG7, TAZ) (OPA1) Mito Disord Panel (mtdna-108 Nuc Genes) x2 (MT-RNR1; MT-TS1) x11 (C10of2; COX6B1; CPT2; FXN; NDUFA1; NDUFS4; SCO2; SDHB (del); SDHC (del); SDHD; SLC25A5) x26 (ACADS; APTX; BCKDHA; BCSIL; COX10; COX15; DBT; DGUOK; FH; MPV17; NDUFS7; NDUFS8; NDUFV1; PDHB; PINK1; RRM2B; SCO1; SDHB; SDHC; SLC22A5; SLC25A20; SPG7; SURF1; TK2; TYMP; Mito del/dup) x19 (ACADVL; ASS1; BCKHB; CPT1A; DBT; DLAT; DLD; HADHA; HADHB; MCCC2; MFN2;NDUFS1; OPA1; PC; PDHX; POLG; SDHA; SPG7; TAZ) (OPA1) x mtdna Genome and 108 Nuc. Genes Del/Dup x2 (SDHC, SLC25A20); x3 (DBT, Mito Genome DD, SPG7) (OPA1) B-Cell Clonality Screening (IgH and IgK) 81261; Sexually Transmitted Disease Panel ; 87591; Gabapentin Quantitative, Urine IDH1 and IDH2 Mutation Analysis, exon x2; FFPE tumor tissue, add BRAF V600E Mutation Detection, FNA 88381; Aortopathy Panel, Seq and Del/Dup x4 (ACTA2; SMAD4; TGFRB1; TGFRB2) x2 (CBS; SMAD4) x2 (FBN1; MYH11) x Aortopathy Del/Dup, 17 Genes (SMAD4) Aortopathy Sequencing, 17 Genes x3 (ACTA2; TGFRB1; TGFRB2) x2 (CBS; SMAD4) x2 (FBN1; MYH11) Page 5 of 7
6 Drug Detection Pan, TOF, Umbilical x2; Mito Disorders (mtdna) Seq and DelDup x2 (MT-RNR1; MT-TS1) x Mito Disorders Nuclear Seq and DelDup x11 (C10of2, COX6B1, CPT2, FXN, NDUFA1, NDUFS4, SCO2, SDHC (del), SDHD, SLC25A20, SLC25A4) x25 (ACADS, APTX, BCKDHA, BCS1L, COX10, COX15, DBT, DGUOK, FH, MPV17, NDUFS7, NDUFS8, NDUFV1, PDHB, PINK1, RRM2B, SCO1, SDHB, SDHC, SLC22A5, SLC25A20, SPG7, SURF1, TK2, TYMP) x19 (ACADVL, ASS1, BCKHB, CPT1A, DBT, DLAT, DLD, HADHA, HADHB, MCCC2, MFN2, NDUFS1, OPA1, PC, PDHX, POLG, SDHA, SPG7, TAZ) (OPA1) x Cytology, FNA w/rflx BRAF V600E, Request FNA-codes; if reflexed, add 88381; Citrullinemia, Type I (ASS1) Sequencing Retinitis Pigmentosa, Seq and Del/Dup x4 (CRX; PRPH2; RHO; RP) x3 (BEST1; CRB1; RPE65) x3 ( ABCA4; CEP290; USH2A) x Retinitis Pigmentosa Sequencing x4 (CRX; PRPH2; RHO; RP) x3 (BEST1; CRB1; RPE65) x3 (ABCA4; CEP290; USH2A) HPGL-PCC (SDHB,C,D) Deletion/Duplication 81404; HPGL-PCC (SDHC) Seq and DelDup 81404; BRAF V600E Detection Hairy Cell, Quant HPGL-PCC (SDHB,C,D) Seq and DelDup Panel x2; x2; ERBB2 (HER2) (4B5) by IHC ERBB2 (HER2) (HercepTest) by IHC Parasite Examination, Macroscopic Vascular Malformations Del/Dup, 10 Genes x2 (ENG; SMAD4) Vasc Malformation Panel, Seq and Del/Dup (PTEN) (PTEN del) x2 (BMPR2; ENG) x2 (PMPR2; ENG) x Vascular Malformations Sequencing (PTEN) x2 (BMPR2; ENG) Succinylacetone, Quantitative, Urine Alpha Subunit, Pit. Glycoprotein Horm Filaggrin (FLG) 2 Mutations Page 6 of 7
7 EPOR Mutation Detection by Sequencing Solid Tumor Mutation Panel by NGS (BRAF) (EGFR) (KRAS) (NPM1) (MPL) x6 (ABL1; CTNNB1; HRAS; IDH1; IDH2;KRAS) x6 ( FGFR2; FGFR3; KIT; NRAS; PDGFRA; RET) (TP53) ; Urine Culture, Invasive Collection 87088; Identification CPT codes may vary based on method Peutz-Jeghers Syndrome (STK11) DelDup Peutz-Jeghers Syndrome (STK11) Seq Peutz-Jeghers Synd (STK11) Seq, DelDup 81404; T-Cell Clonality by NGS BCR-ABL1 Mutation Analysis by NGS Statin Sensitivity (SLCO1B1), 1 Variant Culture, Fluoroquinolone-Rstnt Org 87081; Identification CPT codes may vary based on method Expanded Hearing Loss Panel, Seq/DelDup (GJB2) (GJB6) x2 (CLRN1; USH1G) (DFNB59) x2 (PCDH15; SLC26A4) x3 (MYO7A; PCDH15; USH1C) x2 (CDH23; USH2A) x Expanded Hearing Loss Panel Del/Dup (PCDH15) Metabolic Storage Disorders Sequencing (G6PC) (GBA) (MCOLN1) (SMPD1) (NPC2) x3 (ARSA; GLA; IDS) x5 (GAA; GALC; IDUA; NPC1; PYGM; SLC37A4) (AGL) NASH FibroSURE 0003M Page 7 of 7
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Muscular Dystrophy A Case Study of Positional Cloning Described by Benjamin Duchenne (1868) X-linked recessive disease causing severe muscular degeneration. 100 % penetrance X d Y affected male Frequency
Evaluation of a Microfluidic System for Performance of Fully Automated Companion Diagnostics for Personalized Medicine
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Contents. molecular biology techniques. - Mutations in Factor II. - Mutations in MTHFR gene. - Breast cencer genes. - p53 and breast cancer
Contents Introduction: biology and medicine, two separated compartments What we need to know: - boring basics in DNA/RNA structure and overview of particular aspects of molecular biology techniques - How
Reimbursement for Molecular Diagnostics
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Seattle. Case Presentations. Case 1. 76 year old female with a history of breast cancer 12 years ago. Now presents with a pleural effusion.
Seattle Montreal IAP September 2006 Case Presentations Allen M. Gown, M.D. Medical Director and Chief Pathologist PhenoPath Laboratories Clinical Professor of Pathology University of British Columbia Case
Understanding series. new. directions. 1-800-298-2436 LungCancerAlliance.org. A guide for the patient
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CHROMOSOMES Dr. Fern Tsien, Dept. of Genetics, LSUHSC, NO, LA
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Roberto Ciccone, Orsetta Zuffardi Università di Pavia
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MEDICAL POLICY SUBJECT: PRENATAL GENETIC TESTING. POLICY NUMBER: 4.01.03 CATEGORY: Laboratory Test
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Genes and Cancer. What are genes? Dominant vs. recessive genes
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Case based applications part III
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Invasive Prenatal (Fetal) Diagnostic Testing
MEDICAL POLICY POLICY RELATED POLICIES POLICY GUIDELINES DESCRIPTION SCOPE BENEFIT APPLICATION RATIONALE REFERENCES CODING APPENDIX HISTORY Invasive Prenatal (Fetal) Diagnostic Testing Number 12.04.116
Annex to the Accreditation Certificate D-PL-13372-01-00 according to DIN EN ISO/IEC 17025:2005
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Nuevas tecnologías basadas en biomarcadores para oncología
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Data Analysis for Ion Torrent Sequencing
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Molecular Pathology/Molecular Diagnostics/Genetic Testing
Policy Number GEN01252012RP Approved By UnitedHealthcare Medicare Reimbursement Policy Committee Current Approval Date 01/28/2015 IMPORTANT NOTE ABOUT THIS REIMBURSEMENT POLICY This policy is applicable
Corporate Medical Policy Urinary Tumor Markers for Bladder Cancer
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Medicare National and Local Coverage Determination Policy LA
Medicare National and Local Coverage Determination Policy LA Policies in this MLCP Reference Guide apply to testing performed at a Quest Diagnostics facility and apply to Medicare National Coverage Determination
JOHNS HOPKINS HEALTHCARE
Page 1 of 15 ACTION: New Policy: Effective Date: 08/26/2003 Revising : Review Dates: 03/15/2004, 10/22/2004, Superseding : 10/21/2005, 10/19/2006, 01/07/2008, Archiving : 01/05/2009, 01/07/2011, 06/07/2013,
Molecular analyses of EGFR: mutation and amplification detection
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CPT Generic Test Test Description
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Validation parameters: An introduction to measures of
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Next-generation sequencing can replace Sanger sequencing in clinical diagnostics.
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What is Cancer? Cancer is a genetic disease: Cancer typically involves a change in gene expression/function:
Cancer is a genetic disease: Inherited cancer Sporadic cancer What is Cancer? Cancer typically involves a change in gene expression/function: Qualitative change Quantitative change Any cancer causing genetic
The Role of Genetic Testing in the Evaluation of Thyroid Nodules. Thyroid Cancer and FNA. Thyroid Cancer. Pure Follicular Cancers.
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The Power of Next-Generation Sequencing in Your Hands On the Path towards Diagnostics
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High-Throughput Mutation Profiling Identifies Frequent Somatic Mutations in Advanced Gastric Adenocarcinoma
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Applications of comprehensive clinical genomic analysis in solid tumors: obstacles and opportunities
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The California Prenatal Screening Program
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Overview of Genetic Testing and Screening
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Molecular pathology of thyroid cancers
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Overview of testing for Lynch syndrome/hnpcc
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Molecular Diagnosis of Gastrointestinal Tumors
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Usher Syndrome Genetics
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Tumour Markers. What are Tumour Markers? How Are Tumour Markers Used?
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Product Catalog. HDx Reference Standards Identify and Control Variability Every Day. www.horizondiscovery.com HORIZON DIAGNOSTICS
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