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The CPT® Code 81240 pertains to molecular genetic testing specifically aimed at identifying a mutation in the F2 gene, which encodes for prothrombin, a crucial coagulation factor in the blood clotting process. This particular test focuses on the 20210G>A variant, a well-documented single nucleotide polymorphism that results in a change from guanine to adenine at nucleotide position 20210. This autosomal dominant mutation is significant as it leads to elevated levels of plasma prothrombin, which can increase the risk of thrombotic events. The prevalence of this variant is approximately 2% within the Caucasian population in the United States, with a higher occurrence noted among individuals of southern European descent. Importantly, this genetic variant affects both genders equally and is not restricted to any specific blood type. In the context of inheritance, the presence of just one mutated copy of the gene (heterozygous state) can predispose individuals to various forms of thrombosis, including venous thrombosis in the extremities, cerebral regions, and intra-abdominal areas, as well as arterial thrombosis leading to serious conditions such as myocardial infarction and stroke. Although it is less common, individuals can inherit two mutated copies of the gene (homozygous state), which may further increase their risk. Additionally, women carrying this mutation, whether in a heterozygous or homozygous state, face heightened risks when using oral contraceptives, including the potential for deep vein thrombosis and adverse pregnancy outcomes such as miscarriage and placental complications. Therefore, molecular genetic testing for the F2 gene mutation is particularly indicated for women with histories of infertility or fetal loss, as well as for both men and women who have experienced thrombotic events like deep vein thrombosis, pulmonary embolism, or premature cardiovascular incidents.
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The molecular genetic testing for the F2 (prothrombin, coagulation factor II) gene analysis is indicated for specific clinical scenarios where there is a concern for hereditary hypercoagulability. The following conditions warrant testing:
The procedure for conducting the F2 (prothrombin, coagulation factor II) gene analysis involves several key steps to ensure accurate results. First, a blood sample is collected from the patient, which serves as the source of DNA for testing. This sample is typically obtained through a standard venipuncture technique, ensuring that the collection process is sterile and minimizes the risk of contamination. Once the blood sample is collected, it is sent to a laboratory specializing in molecular genetic testing. In the laboratory, the DNA is extracted from the blood cells using established protocols that isolate the genetic material for analysis. Following extraction, polymerase chain reaction (PCR) techniques are employed to amplify the specific region of the F2 gene that contains the 20210G>A variant. This amplification process is crucial as it increases the quantity of DNA available for testing, allowing for more accurate detection of the mutation. After amplification, the DNA is subjected to sequencing or other molecular techniques to identify the presence of the 20210G>A variant. The results of the analysis are then interpreted by qualified laboratory personnel, who will determine whether the mutation is present and report the findings back to the ordering physician. The entire process is designed to be thorough and precise, ensuring that any genetic predisposition to hypercoagulability is accurately identified.
After the molecular genetic testing for the F2 gene analysis is completed, the patient may not require any specific post-procedure care, as the process is non-invasive and involves only a blood draw. However, it is essential for the healthcare provider to discuss the results with the patient once they are available. If the test indicates the presence of the 20210G>A variant, the physician may recommend further evaluation and management strategies to mitigate the risk of thrombotic events. This may include lifestyle modifications, monitoring for symptoms of thrombosis, or considering anticoagulation therapy, especially in patients with a history of thrombotic events or those who are planning to use oral contraceptives. Additionally, patients should be informed about the implications of the test results for family members, as the autosomal dominant nature of the mutation means that relatives may also be at risk. Overall, the post-procedure phase focuses on ensuring that patients understand their results and the potential next steps in their care.
| Short Descr | F2 GENE | Medium Descr | F2 GENE ANALYSIS 20210G >A VARIANT | Long Descr | F2 (prothrombin, coagulation factor II) (eg, hereditary hypercoagulability) gene analysis, 20210G>A variant | 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) | T1H - Lab tests - other (non-Medicare fee schedule) | MUE | 1 | CCS Clinical Classification | 234 - Pathology |
| 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. | GA | Waiver of liability statement issued as required by payer policy, individual case | 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. | GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | GW | Service not related to the hospice patient's terminal condition | GZ | Item or service expected to be denied as not reasonable and necessary | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | 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. | 91 | Repeat clinical diagnostic laboratory test: in the course of treatment of the patient, it may be necessary to repeat the same laboratory test on the same day to obtain subsequent (multiple) test results. under these circumstances, the laboratory test performed can be identified by its usual procedure number and the addition of modifier 91. note: this modifier may not be used when tests are rerun to confirm initial results; due to testing problems with specimens or equipment; or for any other reason when a normal, one-time, reportable result is all that is required. this modifier may not be used when other code(s) describe a series of test results (eg, glucose tolerance tests, evocative/suppression testing). this modifier may only be used for laboratory test(s) performed more than once on the same day on the same patient. | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2012-01-01 | Added | Added |
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