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The CPT® Code 81233 pertains to the analysis of the BTK (Bruton's tyrosine kinase) gene, specifically focusing on common variant mutations associated with chronic lymphocytic leukemia (CLL). This molecular genetic testing is crucial for identifying specific mutations, namely C481S, C481R, and C481F, which occur at the cysteine 481 codon within the kinase domain of the BTK gene. The BTK gene is located on the long (q) arm of the X chromosome at position 22.1 (Xq22.1) and plays a vital role in the development and function of B-cells, a type of white blood cell responsible for producing antibodies that help the body fight infections. The identified mutations are characterized by single amino acid substitutions: C481S replaces cysteine with serine, C481R replaces cysteine with arginine, and C481F replaces cysteine with phenylalanine. These mutations are significant as they are linked to acquired resistance to targeted therapies such as ibrutinib and acalabrutinib, which are commonly used in the treatment of CLL and mantle cell lymphoma. The testing can be conducted prior to the initiation of treatment or during the course of therapy to inform clinical decisions and optimize patient management.
© Copyright 2025 Coding Ahead. All rights reserved.
The BTK gene analysis using CPT® Code 81233 is indicated for the following conditions:
The procedure for conducting the BTK gene analysis involves several key steps:
After the BTK gene analysis is completed, the healthcare provider will review the results with the patient. Depending on the findings, particularly the presence of mutations associated with drug resistance, treatment plans may be adjusted. This may involve selecting alternative therapies or modifying existing treatment regimens to enhance efficacy. Continuous monitoring and follow-up testing may also be recommended to assess the patient's response to treatment and to identify any further mutations that may arise during therapy.
| Short Descr | BTK GENE COMMON VARIANTS | Medium Descr | BTK GENE ANALYSIS COMMON VARIANTS | Long Descr | BTK (Bruton's tyrosine kinase) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, C481S, C481R, C481F) | 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 | 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. | GW | Service not related to the hospice patient's terminal condition |
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| 2019-01-01 | Added | Added |
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