CPT® Code 81432

1. Indications

The procedure associated with CPT® Code 81432 is indicated for the evaluation of individuals who may be at risk for hereditary breast cancer-related disorders. The specific indications include:

• Hereditary Breast Cancer Individuals with a family history of breast cancer may undergo testing to determine genetic predisposition.
• Hereditary Ovarian Cancer Testing is indicated for those with a family history of ovarian cancer to assess genetic risk factors.
• Hereditary Endometrial Cancer Individuals with a family history of endometrial cancer may be tested to identify potential genetic links.
• Hereditary Pancreatic Cancer Testing may be performed for individuals with a family history of pancreatic cancer to evaluate genetic susceptibility.
• Hereditary Prostate Cancer Individuals with a family history of prostate cancer may be candidates for genetic testing to assess risk.

2. Procedure

The procedure for CPT® Code 81432 involves several detailed steps to ensure accurate genomic analysis. The first step is the extraction of DNA from a specimen of whole blood. This is a critical initial phase, as the quality of the DNA extracted will directly impact the results of the genetic testing. Once the DNA is obtained, it undergoes fragmentation through a process known as sonication. This technique breaks the DNA into smaller, manageable pieces, which is essential for the subsequent analysis.

• Step 1: DNA Extraction The process begins with the collection of a whole blood specimen from the patient, from which DNA is extracted using standard laboratory techniques to ensure high-quality genetic material.
• Step 2: DNA Fragmentation The extracted DNA is then fragmented using sonication, which involves applying sound waves to break the DNA into smaller segments, facilitating easier analysis.
• Step 3: Targeted Gene Enrichment Following fragmentation, the targeted gene segments are enriched through capture hybridization. This step is crucial as it focuses on the specific genes of interest, allowing for a more concentrated analysis of the relevant genetic material.
• Step 4: Sequencing and Analysis The enriched gene segments undergo massively parallel sequencing and/or microarray analysis. This advanced technology enables the simultaneous analysis of multiple gene segments, allowing for the detection of mutations by comparing the sequences and identifying any variations.
• Step 5: Variant Identification The final step involves identifying genetic markers and variations, such as point mutations or single nucleotide polymorphisms, which can provide insights into the patient's genetic predisposition to hereditary cancers.

3. Post-Procedure

After the completion of the genomic sequence analysis, the results are typically reviewed by a qualified healthcare professional. It is essential to provide appropriate counseling to the patient regarding the findings, including the implications of any identified genetic variants. Follow-up care may include discussions about risk management strategies, potential surveillance options, and preventive measures based on the results of the genetic testing. Additionally, patients may be advised on the importance of sharing their genetic information with family members who may also be at risk for hereditary breast cancer-related disorders.