CPT® Code 0794T

1. Indications

The use of CPT® Code 0794T is indicated for patients who require a tailored approach to their cancer treatment based on specific tumor characteristics. The following conditions warrant the application of this algorithm:

• Patient-Specific Cancer Markers Patients with tumor-specific cancer markers that have been previously identified through molecular pathology or immunohistochemical testing.
• Prior Pathology Results Individuals whose cancer treatment options need to be informed by previously interpreted and reported pathology results.
• Need for Targeted Therapy Patients who are candidates for targeted therapies that align with their specific cancer profile, ensuring the use of FDA-approved drugs.

2. Procedure

The procedure associated with CPT® Code 0794T involves several key steps that ensure the effective ranking of treatment options based on the patient's unique cancer characteristics. Each step is crucial for the accurate application of the algorithm:

• Step 1: Data Collection The physician or qualified healthcare professional gathers all relevant clinical data pertaining to the patient's tumor. This includes previously interpreted results from molecular pathology, laboratory tests, and immunohistochemical analyses. It is essential that this data is comprehensive and specific to the patient's cancer markers.
• Step 2: Exclusion of Raw Genomic Data During the data collection process, any raw data from genomic sequencing is explicitly excluded. This ensures that the algorithm operates solely on interpreted results, which have been validated and reported separately, maintaining the integrity of the analysis.
• Step 3: Algorithm Application The collected data is then input into the patient-specific, assistive algorithm. This rules-based system processes the information to evaluate and rank available treatment options, focusing on both single drug therapies and combination therapies that are FDA-approved.
• Step 4: Report Generation Upon completion of the algorithmic analysis, a detailed report is generated. This report outlines the ranked treatment options, providing the physician with a clear overview of the most suitable therapies tailored to the patient's specific cancer profile.
• Step 5: Treatment Planning Finally, the physician reviews the algorithm-generated report to inform subsequent treatment decisions. This step is critical as it allows for a strategic approach to therapy, ensuring that the selected treatments are aligned with the patient's unique tumor characteristics.

3. Post-Procedure

After the application of CPT® Code 0794T and the generation of the treatment ranking report, the physician will engage in a discussion with the patient regarding the recommended treatment options. This may involve explaining the rationale behind the selected therapies and addressing any questions or concerns the patient may have. The physician will then proceed to implement the chosen treatment plan, monitoring the patient's response to therapy and making adjustments as necessary based on ongoing evaluations and clinical outcomes. Continuous follow-up is essential to ensure that the treatment remains effective and aligned with the patient's evolving clinical status.