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The CPT® Code 81437 pertains to molecular genetic testing specifically designed to identify hereditary neuroendocrine tumor-related disorders. These disorders include conditions such as medullary thyroid carcinoma, parathyroid carcinoma, malignant pheochromocytoma, and paraganglioma. The testing involves a genomic sequence analysis panel that examines five or more genes for sequence variants and copy number variants. Neuroendocrine tumors are known to secrete various hormones, including serotonin and histamine, which can lead to a range of symptoms and complications. The panel includes critical genes such as MAX, SDHB, SDHC, SDHD, TMEM127, and VHL, each associated with specific tumor types and syndromes. For instance, mutations in the MAX gene, located on chromosome 7, are linked to pheochromocytoma, while the SDHB, SDHC, and SDHD genes are implicated in hereditary paraganglioma-pheochromocytoma and gastrointestinal stromal tumors (GIST), as well as Carney-Stratakis syndrome. The VHL gene mutations are known to cause von Hippel-Lindau disease, which is also associated with pheochromocytomas. The testing process typically involves collecting whole blood samples, which are then analyzed using polymerase chain reaction (PCR) techniques combined with DNA sequencing. This method allows for the enrichment of targeted gene segments through capture hybridization, followed by massively parallel sequencing or microarray analysis to detect mutations. The analysis focuses on identifying genetic markers and variations, including point mutations and single nucleotide polymorphisms, which can provide insights into the genetic basis of these disorders. Various techniques are employed to interrogate both sequence variants and copy number variants, aiding in the detection of large structural rearrangements and the interpretation of the effects of these genetic variants.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure associated with CPT® Code 81437 is indicated for the evaluation of hereditary neuroendocrine tumor-related disorders. These include:
The procedure for CPT® Code 81437 involves several key steps to perform genomic sequence analysis. First, a sample of whole blood is collected from the patient. This sample serves as the source of DNA for the analysis. Next, the DNA is extracted from the blood sample, which is a critical step to ensure that high-quality genetic material is available for testing. Following extraction, polymerase chain reaction (PCR) techniques are employed to amplify specific regions of the DNA that correspond to the genes of interest, which include MAX, SDHB, SDHC, SDHD, TMEM127, and VHL. This amplification process is essential for obtaining sufficient quantities of DNA for detailed analysis. After amplification, capture hybridization is utilized to enrich the targeted gene segments, allowing for a more focused analysis of the relevant areas of the genome. Subsequently, massively parallel sequencing and/or microarray analysis are applied to the enriched target regions. This advanced sequencing technology enables the detection of gene mutations by comparing the sequenced gene segments to reference sequences, identifying any variations that may indicate the presence of hereditary neuroendocrine tumor-related disorders. The analysis specifically looks for sequence variants, such as point mutations or single nucleotide polymorphisms, as well as copy number variants, which can reveal large structural rearrangements in the genetic material. The results of this comprehensive genomic analysis provide valuable insights into the genetic predisposition to these tumors and can guide further clinical management.
Post-procedure care following the genomic sequence analysis typically involves the interpretation of the test results by a qualified healthcare professional. Patients may be advised on the implications of the findings, including potential risks for hereditary neuroendocrine tumors and the need for further monitoring or preventive measures. Genetic counseling may also be recommended to help patients and their families understand the results and the associated risks. Additionally, follow-up appointments may be scheduled to discuss any necessary interventions or additional testing based on the results of the genomic analysis. It is important for patients to be informed about the significance of the genetic findings and how they may impact their health and that of their relatives.
| Short Descr | HERED NEUROEND TUM-RLT DO 5+ | Medium Descr | HERED NEUROEND TUM-RELATED DO GEN SEQ ALYS 5+ | Long Descr | Hereditary neuroendocrine tumor-related disorders (eg, medullary thyroid carcinoma, parathyroid carcinoma, malignant pheochromocytoma or paraganglioma), genomic sequence analysis panel, 5 or more genes, interrogation for sequence variants and copy number 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 |
| 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. | 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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| 2025-01-01 | Changed | Short, Medium, and Long Descriptions changed. |
| 2016-01-01 | Added | Added |
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