Question:

What codes would be reported for targeted genomic sequence analysis?

Answer:

CPT® codes 81445, 81450, and 81455 (partial descriptors below) describe targeted genomic sequence analyses. The codes differ based on the type of neoplasm (hematolymphoid or solid organ) and the number of genes analyzed. Medicare payment policy requires that a physician report only one of these codes for a hematolymphoid or solid-organ neoplasm on a single date of service depending upon the total number of genes analyzed.

81445 Targeted genomic sequence analysis panel, solid organ neoplasm, DNA analysis, and RNA analysis when performed, 5-50 genes …, interrogation for sequence variants and copy number variants or rearrangements, if performed
81450 Targeted genomic sequence analysis panel, hematolymphoid neoplasm or disorder, DNA analysis, and RNA analysis when performed, 5-50 genes…, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mRNA expression levels, if performed
81455 Targeted genomic sequence analysis panel, solid organ or hematolymphoid neoplasm, DNA analysis, and RNA analysis when performed, 51 or greater genes …, interrogation for sequence variants and copy number variants or rearrangements, if performed

CPT® is a registered trademark of the American Medical Association.

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CPT® copyright 2024 American Medical Association (AMA). All rights reserved.

Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

CPT is a registered trademark of the American Medical Association.

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