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The CPT® Code 81342 pertains to the molecular genetic testing of the T cell antigen receptor, gamma (TRG@) gene, which is located on chromosome 7. This test is specifically designed to analyze gene rearrangements that may indicate the presence of abnormal clonal populations, which are often associated with certain types of leukemia and lymphoma. T cell antigen receptors play a crucial role in the immune system, as they are responsible for recognizing foreign antigens—small peptide fragments that are presented by major histocompatibility complex (MHC) molecules on the surface of antigen-presenting cells (APCs). The structure of T cell antigen receptors is similar to that of immunoglobulin genes and is composed of various gene segments that come together to form functional receptors. The T cell antigen receptor is primarily made up of alpha/beta chains (approximately 95%) and gamma/delta chains (about 5%). The focus of this test is on the gamma T cell antigen receptor, which is a smaller subset of T cell receptors predominantly found in intraepithelial lymphocytes within the gut and, to a lesser extent, in the skin. The gamma subunits of these receptors contain variable (V) regions that are crucial for defining the characteristics of the T cells. The testing process typically employs non-radioactive polymerase chain reaction-single strand conformational polymorphism (PCR-SSCP) techniques, along with histological and immunophenotypic analyses, to effectively detect any abnormal clonal populations. This comprehensive gene expression analysis is instrumental in evaluating the immune response related to various conditions, particularly those affecting blood cells and the lymphatic system, including cancers.
© Copyright 2025 Coding Ahead. All rights reserved.
The CPT® Code 81342 is indicated for use in the evaluation of patients suspected of having certain hematological malignancies, specifically those involving leukemia and lymphoma. The test is performed to detect abnormal clonal populations of T cells that may be associated with these conditions. The following are the explicit indications for this procedure:
The procedure for CPT® Code 81342 involves several critical steps to ensure accurate analysis of the T cell antigen receptor, gamma (TRG@) gene rearrangements. The following procedural steps are outlined:
After the completion of the procedure associated with CPT® Code 81342, the patient may not require any specific post-procedure care related to the testing itself. However, it is essential for healthcare providers to discuss the results with the patient once they are available. The interpretation of the test results can have significant implications for the patient's diagnosis and treatment plan, particularly in the context of leukemia and lymphoma. Follow-up appointments may be necessary to discuss further diagnostic steps or treatment options based on the findings of the gene rearrangement analysis.
| Short Descr | TRG GENE REARRANGEMENT ANAL | Medium Descr | TRG@ GENE REARRANGEMENT ANALYSIS | Long Descr | TRG@ (T cell antigen receptor, gamma) (eg, leukemia and lymphoma), 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 |
| GZ | Item or service expected to be denied as not reasonable and necessary | 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. | 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. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 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. | 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 | GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | 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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| 2013-01-01 | Changed | Guideline information changed. |
| 2012-01-01 | Added | Added |
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