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The CPT® Code 81272 pertains to molecular genetic testing specifically aimed at analyzing the KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) gene. This gene is crucial in various oncological conditions, including gastrointestinal stromal tumors (GIST), acute myeloid leukemia, and melanoma. The testing involves targeted sequence analysis of specific exons—namely exons 8, 11, 13, 17, and 18—located on chromosome 4. The KIT gene encodes a receptor protein that is part of the tyrosine kinase family, which plays a vital role in signal transduction. This process is initiated when a stem cell factor binds to the receptor, leading to the activation of intracellular proteins through phosphorylation. This activation cascade is essential for various cellular functions, including proliferation, survival, and migration, particularly in germ cells, hematopoietic stem cells, mast cells, gastrointestinal cells, and melanocytes. Mutations in the KIT gene are linked to several conditions, such as piebaldism, GIST, acute myeloid leukemia, sinonasal natural killer/T-cell lymphoma (NKTCL), and melanoma. The purpose of conducting genetic testing on the KIT gene is to identify specific mutations in patients diagnosed with these cancers, which can provide critical information regarding prognosis and the potential response or resistance to targeted cancer therapies.
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The molecular genetic testing for the KIT gene is indicated for patients diagnosed with specific types of cancer where KIT mutations may play a significant role in disease progression and treatment response. The following conditions are explicitly mentioned as indications for this testing:
The procedure for conducting the molecular genetic testing of the KIT gene involves several key steps, which are outlined as follows:
After the molecular genetic testing is completed, the results are typically reviewed by a healthcare professional, such as an oncologist or genetic counselor. The findings can provide valuable insights into the patient's prognosis and potential treatment pathways. Patients may require follow-up consultations to discuss the implications of the test results, including any necessary adjustments to their treatment plan based on the identified KIT mutations. Additionally, the results may inform decisions regarding targeted therapies that could be more effective based on the specific genetic alterations present.
| Short Descr | KIT GENE TARGETED SEQ ANALYS | Medium Descr | KIT GENE ANALYSIS TARGETED SEQUENCE ANALYSIS | Long Descr | KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, gastrointestinal stromal tumor [GIST], acute myeloid leukemia, melanoma), gene analysis, targeted sequence analysis (eg, exons 8, 11, 13, 17, 18) | 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 |
| 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 | 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. | 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 | GZ | Item or service expected to be denied as not reasonable and necessary |
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| 2016-01-01 | Added | Added |
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