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The CPT® Code 81273 pertains to molecular genetic testing specifically aimed at identifying the D816 variant(s) mutation of the KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) gene located on chromosome 4. The KIT gene is crucial as it encodes a protein that is part of the receptor tyrosine kinase family, which plays a significant role in signal transduction. This process involves the transmission of signals from the cell surface into the interior of the cell, facilitating various cellular functions. The D816 variant is characterized by a somatic A to T missense mutation at position 2447 of the coding sequence, leading to a critical substitution of aspartate (D) with valine (V) at position 816 within the kinase domain. This mutation results in the autoactivation of the KIT receptor tyrosine kinase, which can lead to the development of mastocytosis. Mastocytosis is a condition marked by the excessive production of mast cells, which can manifest in two primary forms: cutaneous mastocytosis, affecting the skin, and systemic mastocytosis, impacting internal organs. In cutaneous mastocytosis, often seen in children, mast cells accumulate in the skin, leading to symptoms such as flushing and itching. Conversely, systemic mastocytosis primarily affects adults and involves the accumulation of mast cells in organs such as the liver, spleen, bone marrow, and small intestine, resulting in a range of symptoms including flushing, itching, abdominal cramps, musculoskeletal pain, hypotension, and potentially life-threatening anaphylaxis. To perform this genetic analysis, blood, bone marrow, or skin samples are collected, typically through procedures such as venipuncture, bone marrow aspiration, or biopsy. The samples are then analyzed for the presence of D816 variant(s) mutation using an allele-specific real-time polymerase chain reaction assay.
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The molecular genetic testing represented by CPT® Code 81273 is indicated for the evaluation of patients suspected of having mastocytosis, particularly when there is a need to identify the D816 variant(s) mutation of the KIT gene. The following conditions and symptoms may warrant this testing:
The procedure for conducting the molecular genetic testing under CPT® Code 81273 involves several critical steps to ensure accurate identification of the D816 variant(s) mutation. The following procedural steps are outlined:
After the molecular genetic testing is completed, the results are analyzed and interpreted by a qualified healthcare professional. The findings will inform the diagnosis of mastocytosis and guide subsequent treatment options. Patients may require follow-up consultations to discuss the results and any necessary management strategies based on the presence of the D816 variant(s) mutation. Additionally, healthcare providers may monitor patients for symptoms associated with mastocytosis and adjust treatment plans accordingly to address any complications that may arise.
| Short Descr | KIT GENE ANALYS D816 VARIANT | Medium Descr | KIT GENE ANALYSIS D816 VARIANT(S) | Long Descr | KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (eg, mastocytosis), gene analysis, D816 variant(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 |
| 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 | 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. | 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. | 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 |
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| 2016-01-01 | Added | Added |
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