CPT® Code 81262

Official Description

IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); direct probe methodology (eg, Southern blot)

Common Language Description

The CPT® Code 81262 pertains to the analysis of the immunoglobulin heavy chain locus (IGH@) for gene rearrangement, specifically aimed at detecting abnormal clonal populations associated with leukemias and lymphomas, particularly B-cell malignancies. The IGH@ locus is located on chromosome 14 and plays a crucial role in the immune system by producing immunoglobulins, which are essential for recognizing foreign antigens and initiating immune responses. Each immunoglobulin molecule is composed of two identical heavy chains and two identical light chains, which are vital for their function. During the development of B-cells, complete rearrangement of the IGH gene occurs in a stage-specific manner, allowing for the generation of diverse antibodies. Abnormalities in the IGH@ gene, including mutations and rearrangements, have been linked to various blood cancers, making this testing significant for diagnosis and treatment planning. The gene rearrangement analysis can be performed using different methodologies, including amplified techniques like polymerase chain reaction (PCR) or direct probe methodologies such as the Southern blot technique. The Southern blot method involves separating DNA fragments through electrophoresis, followed by transferring these fragments to a membrane where they can be identified and tagged using specific probes. This technique is essential for detecting the presence of abnormal clonal populations, which can provide critical information regarding the nature of the malignancy and guide therapeutic decisions.

1. Indications

The procedure associated with CPT® Code 81262 is indicated for the analysis of the immunoglobulin heavy chain locus (IGH@) in patients suspected of having hematological malignancies, particularly those involving B-cells. The following conditions may warrant this testing:

Leukemias The presence of abnormal clonal populations in leukemias can indicate the type and progression of the disease.
Lymphomas Testing is crucial for diagnosing and classifying various types of lymphomas, especially B-cell lymphomas.
Monitoring Treatment Response The analysis can be used to assess how well a patient is responding to treatment by detecting changes in clonal populations.
Prognostic Assessment Identifying specific gene rearrangements can help predict disease outcomes and guide therapeutic strategies.

2. Procedure

The procedure for CPT® Code 81262 involves several key steps to perform the gene rearrangement analysis using direct probe methodology, specifically the Southern blot technique. The following procedural steps are outlined:

Step 1: Sample Collection A biological sample, typically blood or bone marrow, is collected from the patient. This sample contains the B-cells that will be analyzed for IGH@ gene rearrangements.
Step 2: DNA Extraction The collected sample undergoes a process to extract DNA, isolating it from other cellular components. This step is crucial for obtaining pure DNA for analysis.
Step 3: DNA Fragmentation The extracted DNA is then subjected to electrophoresis, which separates the DNA into fragments based on size. This step is essential for visualizing the DNA segments that will be analyzed.
Step 4: Transfer to Membrane After electrophoresis, the separated DNA fragments are transferred to a membrane, a critical step that allows for the subsequent identification of specific DNA sequences.
Step 5: Probe Hybridization Specific probes that bind to the target IGH@ gene rearrangements are applied to the membrane. These probes are designed to hybridize with the complementary DNA sequences, allowing for the detection of abnormal clonal populations.
Step 6: Visualization The hybridized probes are then visualized, typically through a labeling system that indicates the presence of the target gene rearrangements. This final step confirms the presence of abnormal clonal populations, providing essential information for diagnosis and treatment planning.

3. Post-Procedure

After the completion of the gene rearrangement analysis using CPT® Code 81262, the results are interpreted by a qualified healthcare professional. The findings can provide critical insights into the presence of abnormal clonal populations, which may influence treatment decisions and prognostic assessments. Patients may require follow-up consultations to discuss the results and any necessary next steps in their care. Additionally, the healthcare provider may recommend further testing or monitoring based on the results of the analysis. It is important for patients to understand the implications of the findings and how they relate to their overall treatment plan.

Short Descr	IGH GENE REARRANG DIR PROBE
Medium Descr	IGH@ REARRANGE ABNORMAL CLONAL POP DIRECT PROBE
Long Descr	IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); direct probe methodology (eg, Southern blot)
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