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The CPT® Code 81232 pertains to the gene analysis of the dihydropyrimidine dehydrogenase (DPYD) gene, which plays a crucial role in the metabolism of certain chemotherapeutic agents, specifically 5-fluorouracil (5-FU) and capecitabine. This analysis focuses on identifying common genetic variants, such as *2A, *4, *5, and *6, that can influence how patients metabolize these drugs. The DPYD gene is located on the short (p) arm of chromosome 1 at position 21.3, and it encodes an enzyme that is essential for the breakdown of pyrimidine nucleotides, which include uracil and thymine, as well as drugs that share similar structures. Understanding the genetic variants present in a patient can help predict their risk of experiencing dose-related toxicity when undergoing treatment with 5-FU or capecitabine. Notably, the *2A allele is linked to a significantly increased risk of drug toxicity, making it the most frequently identified variant in this context. In contrast, the *4, *5, and *6 alleles are associated with normal gene function, indicating that individuals with these variants may metabolize the drugs without heightened risk. The testing process involves obtaining a blood sample, which is then analyzed using polymerase chain reaction (PCR) techniques with fluorescence monitoring to detect the presence of these genetic variants.
© Copyright 2025 Coding Ahead. All rights reserved.
The gene analysis represented by CPT® Code 81232 is indicated for patients who are being considered for treatment with chemotherapeutic agents such as 5-fluorouracil (5-FU) or capecitabine. The analysis aims to identify specific genetic variants in the DPYD gene that may affect drug metabolism and influence the risk of dose-related toxicity. This testing is particularly relevant for patients with a history of adverse reactions to these medications or those who may be at higher risk due to genetic predispositions.
The procedure for CPT® Code 81232 involves several key steps to ensure accurate analysis of the DPYD gene variants. First, a blood sample is collected from the patient, which serves as the biological material for testing. This sample must be obtained through a separately reportable procedure, ensuring that proper protocols are followed for specimen collection. Once the blood sample is secured, it is sent to a laboratory equipped to perform genetic testing. The laboratory utilizes polymerase chain reaction (PCR) techniques, which amplify specific segments of the DNA to facilitate the detection of the DPYD gene variants. Fluorescence monitoring is employed during the PCR process to identify the presence of the common variants, including *2A, *4, *5, and *6. The results of this analysis will indicate whether the patient carries any of these variants, which can inform treatment decisions and risk assessments regarding chemotherapy.
After the completion of the gene analysis for CPT® Code 81232, the laboratory will provide a report detailing the presence or absence of the identified DPYD gene variants. Healthcare providers will review these results to determine the appropriate course of action regarding the patient's chemotherapy treatment. If the *2A allele is detected, the provider may consider adjusting the dosage of 5-FU or capecitabine or exploring alternative treatment options to mitigate the risk of toxicity. Patients may also be monitored more closely for any adverse reactions if they possess variants associated with normal gene function. It is essential for healthcare providers to communicate the results to the patient and discuss any necessary changes to their treatment plan based on the findings of the genetic analysis.
| Short Descr | DPYD GENE COMMON VARIANTS | Medium Descr | DPYD GENE ANALYSIS COMMON VARIANTS | Long Descr | DPYD (dihydropyrimidine dehydrogenase) (eg, 5-fluorouracil/5-FU and capecitabine drug metabolism), gene analysis, common variant(s) (eg, *2A, *4, *5, *6) | Status Code | Statutory Exclusion (from MPFS, may be paid under other methodologies) | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 9 - Not Applicable | Multiple Procedures (51) | 9 - Concept does not apply. | Bilateral Surgery (50) | 9 - Concept does not apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 9 - Concept does not apply. | Co-Surgeons (62) | 9 - Concept does not apply. | Team Surgery (66) | 9 - Concept does not apply. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | CLIA Waived (QW) | No | APC Status Indicator | Service Paid under Fee Schedule or Payment System other than OPPS | Type of Service (TOS) | 5 - Diagnostic Laboratory | Berenson-Eggers TOS (BETOS) | none | MUE | 1 |
| 90 | Reference (outside) laboratory: when laboratory procedures are performed by a party other than the treating or reporting physician or other qualified health care professional, the procedure may be identified by adding modifier 90 to the usual procedure number. | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | GZ | Item or service expected to be denied as not reasonable and necessary | 26 | Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number. | GA | Waiver of liability statement issued as required by payer policy, individual case | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GW | Service not related to the hospice patient's terminal condition |
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| 2020-03-02 | Changed | Medium description changed per CPT Errata |
| 2018-01-01 | Added | Code Added. |
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