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The CPT® Code 81443 pertains to genetic testing specifically designed for the identification of severe inherited conditions. This testing utilizes a genomic sequence analysis panel that must include the sequencing of at least 15 genes. Among the conditions that can be identified through this testing are cystic fibrosis and various disorders associated with Ashkenazi Jewish ancestry, such as Bloom syndrome, Canavan disease, and Gaucher disease, among others. The genetic panel encompasses a range of genes, including but not limited to ACADM, ARSA, ASPA, ATP7B, BCKDHA, BCKDHB, BLM, CFTR, DHCR7, FANCC, G6PC, GAA, GALT, GBA, GBE1, HBB, HEXA, IKBKAP, MCOLN1, and PAH. Genomic sequencing is a critical process that determines the precise order of amino acids, or bases, that constitute DNA molecules. This analysis examines all coding exons of the genes included in the panel, allowing for the detection of various genetic mutations, including deletion/duplication mutations, insertion mutations, single nucleotide polymorphisms (SNPs), structural variations (SV), and copy number variations (CNVs). The application of genomic panel testing is significant in clinical settings, as it may be indicated for confirming a clinical diagnosis, identifying at-risk family members, and determining carrier status during prenatal assessments. This comprehensive approach to genetic testing plays a vital role in the early detection and management of severe inherited conditions.
© Copyright 2025 Coding Ahead. All rights reserved.
The genetic testing represented by CPT® Code 81443 is indicated for the following severe inherited conditions:
The procedure for CPT® Code 81443 involves several critical steps to ensure accurate genetic testing for severe inherited conditions:
After the completion of the genetic testing procedure under CPT® Code 81443, patients may receive counseling regarding the results. This counseling is essential for understanding the implications of any identified genetic conditions, including potential health risks for the patient and their family members. Additionally, healthcare providers may discuss options for further testing, management strategies, and the importance of informing at-risk relatives. Follow-up appointments may be scheduled to address any questions or concerns regarding the results and to provide support for any necessary medical or psychological interventions.
| Short Descr | GENETIC TSTG SEVERE INH COND | Medium Descr | GENETIC TESTING FOR SEVERE INHERITED CONDITIONS | Long Descr | Genetic testing for severe inherited conditions (eg, cystic fibrosis, Ashkenazi Jewish-associated disorders [eg, Bloom syndrome, Canavan disease, Fanconi anemia type C, mucolipidosis type VI, Gaucher disease, Tay-Sachs disease], beta hemoglobinopathies, phenylketonuria, galactosemia), genomic sequence analysis panel, must include sequencing of at least 15 genes (eg, ACADM, ARSA, ASPA, ATP7B, BCKDHA, BCKDHB, BLM, CFTR, DHCR7, FANCC, G6PC, GAA, GALT, GBA, GBE1, HBB, HEXA, IKBKAP, MCOLN1, PAH) | 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. | GA | Waiver of liability statement issued as required by payer policy, individual case | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GW | Service not related to the hospice patient's terminal condition | 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 | GZ | Item or service expected to be denied as not reasonable and necessary |