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The CPT® Code 81310 pertains to the molecular genetic testing specifically aimed at identifying mutations in the NPM1 gene, which is located on chromosome 5. This gene encodes for a protein known as nucleolar phosphoprotein B23, also referred to as numatrin. The NPM1 protein plays a crucial role in the biosynthesis of ribosomes and is involved in various cellular processes, including the binding of single-stranded nucleic acids and the transport of small proteins between the cell nucleus and the cytoplasm. Under certain conditions, such as serum starvation or treatment with antineoplastic drugs, this protein can translocate from the nucleolus to the nucleoplasm, indicating its dynamic role in cellular function. Mutations in the NPM1 gene are associated with the development of acute myeloid leukemia (AML), as they are believed to influence tumor growth by altering the activation mechanisms within the p53/ARF pathway, which is critical for regulating cell cycle and apoptosis. Therefore, genetic testing for NPM1 mutations serves as a valuable prognostic tool in newly diagnosed cases of acute myeloid leukemia, helping to inform treatment decisions and predict patient outcomes.
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The NPM1 gene analysis, as indicated by CPT® Code 81310, is performed primarily for the following conditions:
The procedure for conducting the NPM1 gene analysis involves several key steps to ensure accurate identification of mutations. First, a sample of the patient's blood or bone marrow is collected, which contains the necessary genetic material for analysis. Next, the sample undergoes processing to extract DNA, which is then subjected to amplification techniques, such as polymerase chain reaction (PCR), to increase the quantity of the target gene segment. Following amplification, specific primers are used to selectively amplify exon 12 of the NPM1 gene, where mutations are commonly found. The amplified DNA is then analyzed using sequencing methods to identify any variants present in the gene. This detailed examination allows for the detection of mutations that may influence the prognosis and treatment options for the patient diagnosed with acute myeloid leukemia.
After the NPM1 gene analysis is completed, the results are compiled and interpreted by a qualified healthcare professional. The findings can provide critical prognostic information regarding the patient's acute myeloid leukemia, influencing treatment decisions and management strategies. Patients may be monitored for any clinical changes or responses to treatment based on the genetic findings. Additionally, it is essential for healthcare providers to discuss the results with the patient, including the implications of the identified mutations and potential next steps in their treatment plan.
| Short Descr | NPM1 GENE | Medium Descr | NPM1 NUCLEOPHOSMIN GENE ANAL EXON 12 VARIANTS | Long Descr | NPM1 (nucleophosmin) (eg, acute myeloid leukemia) gene analysis, exon 12 variants | 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 |
| 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. | 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. | GZ | Item or service expected to be denied as not reasonable and necessary | 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. | GA | Waiver of liability statement issued as required by payer policy, individual case | 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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