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The CPT® Code 81264 refers to a specific molecular genetic test that focuses on the immunoglobulin kappa light chain locus (IGK@), which is located on chromosome 2. This test is primarily utilized in the evaluation of certain hematological conditions, particularly leukemia and lymphoma, specifically those involving B-cells. The immunoglobulin kappa light chain plays a crucial role in the immune system by recognizing foreign antigens and initiating an immune response. It is important to note that immunoglobulin light chains are composed of small polypeptide subunits, which can be categorized into two types: kappa, found on chromosome 2, and lambda, located on chromosome 22. The IGK@ gene rearrangement analysis is significant because it allows for the detection of abnormal clonal populations within blood and lymphatic tissues. This is achieved through advanced techniques such as polymerase chain reaction (PCR), which enhances the accuracy of identifying clonal immunoglobulin gene rearrangements compared to other assays, such as those targeting the immunoglobulin heavy chain locus (IGH@). Furthermore, the IGKV configuration is less frequently subjected to somatic hypermutation than the IGHV configuration, making the IGK@ assay a valuable tool in routine clonality analysis, particularly in the diagnosis of lymphatic neoplasms. This testing is essential for clinicians to accurately diagnose and manage conditions related to abnormal clonal populations in hematological malignancies.
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The IGK@ gene rearrangement analysis (CPT® Code 81264) is indicated for the evaluation of specific hematological conditions, particularly:
The procedure for conducting the IGK@ gene rearrangement analysis involves several critical steps to ensure accurate results:
After the IGK@ gene rearrangement analysis is completed, the following post-procedure considerations are important:
Patients may not require any specific post-procedure care related to the test itself, as it is a laboratory analysis performed on a sample. However, clinicians should review the results in conjunction with other clinical findings and diagnostic tests to make informed decisions regarding the patient's diagnosis and treatment plan. Follow-up appointments may be necessary to discuss the results and any further testing or treatment options that may be indicated based on the findings of the IGK@ analysis.
| Short Descr | IGK REARRANGEABN CLONAL POP | Medium Descr | IGK@ GENE REARRANGE DETECT ABNORMAL CLONAL POP | Long Descr | IGK@ (Immunoglobulin kappa light chain locus) (eg, leukemia and lymphoma, B-cell), gene rearrangement analysis, evaluation to detect abnormal clonal population(s) | 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 |
| XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | 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. | 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. | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 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. | 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. | GA | Waiver of liability statement issued as required by payer policy, individual case | GC | This service has been performed in part by a resident under the direction of a teaching physician | GW | Service not related to the hospice patient's terminal condition | GZ | Item or service expected to be denied as not reasonable and necessary |
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| 2013-01-01 | Changed | Guideline information changed. |
| 2012-01-01 | Added | Added |
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