CPT® Code 81341

Official Description

TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using direct probe methodology (eg, Southern blot)

Common Language Description

The CPT® Code 81341 pertains to the molecular genetic testing of the T cell antigen receptor beta (TRB@) gene, which is located on chromosome 7. This testing is crucial for identifying mutations that may be responsible for certain types of leukemia and lymphoma. The T cell antigen receptor plays a vital role in the immune system, as it enables T cells to recognize and respond to foreign antigens, which are small peptides presented by major histocompatibility complex (MHC) molecules on antigen presenting cells (APC). The structure of T cell antigen receptors is formed from various independent gene segments, similar to immunoglobulin genes. The TRB@ gene specifically encodes the beta chain of the T cell antigen receptor, which is predominantly composed of alpha/beta chains (approximately 95%) and a smaller proportion of gamma/delta chains (about 5%). The analysis performed under this code utilizes direct probe methodology, such as Southern blotting, to detect abnormal clonal populations of T cells. This method involves the use of a single-strand DNA probe that is either radioactively labeled or enzyme-bound, allowing for the identification of specific base pairings and the sequencing of the gene. The comprehensive gene expression analysis provided by this testing can evaluate the human T cell receptor beta variable (TCRBV) proteins, which are essential for understanding the body's immune response to various conditions, particularly those affecting blood cells and the lymphatic system. By identifying the presence of abnormal clonal populations, healthcare professionals can gain insights into the underlying mechanisms of certain hematological malignancies, thereby aiding in diagnosis and treatment planning.

1. Indications

The procedure associated with CPT® Code 81341 is indicated for the detection of abnormal clonal populations of T cells, which may be present in various hematological malignancies. The following conditions are explicitly mentioned as indications for this testing:

Leukemia - A type of cancer that affects blood cells and bone marrow, characterized by the uncontrolled proliferation of abnormal white blood cells.
Lymphoma - A group of blood cancers that develop in the lymphatic system, which is part of the immune system, leading to the growth of abnormal lymphocytes.

2. Procedure

The procedure for CPT® Code 81341 involves several key steps to perform the gene rearrangement analysis using direct probe methodology. The following procedural steps are outlined:

Sample Collection - A biological sample, typically blood or bone marrow, is collected from the patient to obtain the necessary DNA for analysis.
DNA Extraction - The DNA is extracted from the collected sample using standard laboratory techniques to ensure that it is suitable for further analysis.
Probe Preparation - A single-strand DNA probe is prepared, which may be labeled with a radioactive isotope or an enzyme. This probe is designed to specifically bind to the target sequences of the TRB@ gene.
Hybridization - The prepared probe is then hybridized to the denatured DNA sample. This step allows the probe to bind to complementary sequences in the target DNA, forming hybrid DNA molecules.
Detection - The hybridized DNA is subjected to detection methods, such as autoradiography or enzyme-based assays, to visualize the presence of the TRB@ gene rearrangements. This step is crucial for identifying any abnormal clonal populations.
Analysis and Interpretation - The results are analyzed to determine the presence of abnormal clonal populations, which can provide insights into the diagnosis and management of leukemia and lymphoma.

3. Post-Procedure

After the completion of the procedure associated with CPT® Code 81341, the following post-procedure considerations are important:

Patients may be monitored for any immediate reactions to the sample collection process, particularly if bone marrow was obtained. The results of the gene rearrangement analysis will typically be reviewed by a healthcare professional, who will interpret the findings in the context of the patient's clinical history and symptoms. Follow-up appointments may be scheduled to discuss the results and potential next steps in diagnosis or treatment, depending on the presence of abnormal clonal populations detected during the analysis. It is essential for healthcare providers to communicate the results clearly to the patient and to consider any further testing or interventions that may be necessary based on the findings.

Short Descr	TRB@ GENE REARRANGE DIRPROBE
Medium Descr	TRB@ REARRANGEMENT ANAL DIRECT PROBE METHODOLOGY
Long Descr	TRB@ (T cell antigen receptor, beta) (eg, leukemia and lymphoma), gene rearrangement analysis to detect abnormal clonal population(s); using 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