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The CPT® Code 81345 pertains to the molecular genetic testing of the TERT (telomerase reverse transcriptase) gene, specifically focusing on targeted sequence analysis of its promoter region. This analysis is particularly relevant in the context of certain malignancies, such as thyroid carcinoma and glioblastoma multiforme. The TERT gene, located on the short (p) arm of chromosome 5 at position 15.33 (5p15.33), plays a crucial role in cellular aging and cancer biology by encoding the hTERT component of the telomerase enzyme. This enzyme is responsible for adding telomeres, which are protective DNA segments, to the ends of chromosomes, thereby regulating telomere length and contributing to cellular immortality in cancer cells. Mutations within the promoter region of the TERT gene are typically characterized as point mutations or small insertion/deletion mutations. The identification of these mutations through targeted sequence analysis is essential for tumor classification and can provide valuable prognostic information regarding the disease. By determining the presence, absence, and specific type of mutation, healthcare professionals can gain insights into the biological behavior of the tumor, which may influence treatment decisions and patient management. The code 81345 specifically reports the targeted sequence analysis of the TERT gene's promoter region, enabling the detection of functional variants and the exploration of intrinsic features that may reveal active sites for post-translational modifications, as well as any insertion, deletion, or point mutations that may be present.
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The TERT gene analysis using CPT® Code 81345 is indicated for the evaluation of specific malignancies, particularly:
The procedure for CPT® Code 81345 involves several key steps to ensure accurate analysis of the TERT gene's promoter region:
After the completion of the TERT gene analysis, healthcare providers will review the results to inform clinical decision-making. The findings may influence treatment strategies, including the choice of therapies and the overall management of the patient's condition. Patients may be monitored for any changes in their health status, and follow-up consultations may be scheduled to discuss the implications of the test results and any necessary next steps in their care.
| Short Descr | TERT GENE TARGETED SEQ ALYS | Medium Descr | TERT GENE ANALYSIS TARGETED SEQUENCE ANALYSIS | Long Descr | TERT (telomerase reverse transcriptase) (eg, thyroid carcinoma, glioblastoma multiforme) gene analysis, targeted sequence analysis (eg, promoter region) | 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) | none | 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 | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | GW | Service not related to the hospice patient's terminal condition | 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. | 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. | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider |
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| 2019-01-01 | Added | Added |
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