The molecular lab studies biological molecules, including DNA, RNA, and proteins. Another name for the molecular lab is molecular biology. The molecular lab studies the genetic structure and vital molecular processes in medicine.
The development of molecular biology in the modern era has significantly impacted the healthcare world. This has dramatically advanced our understanding of various conditions and genetic abnormalities. It serves multiple purposes, particularly in research and development, including biotechnology, genetic engineering, and medication discovery.
CPT Codes for molecular lab tests typically fall under the Pathology and Laboratory section of the CPT code set. The exact codes and descriptions will depend on the specific test and the laboratory conducting the test. Molecular lab CPT codes are generally classified under the Pathology and Laboratory category of the CPT code set.
So, without further delay, let’s discover the standard CPT codes used in molecular labs as well as an explanation of these codes.
Molecular Lab Testing CPT Codes
Genetic Testing (CPT codes 81200-81408)
These codes are used for various genetic tests such as sequencing, deletion/duplication analysis, and chromosomal microarray analysis.
- 81200: This code is used for the targeted genomic sequence analysis panel, which means a specific set of genes is analyzed for mutations or variations.
- 81301: A comprehensive hereditary cancer panel uses this code to examine several genes related to different types of cancers.
- 81405: This code is used for whole exome sequencing, which examines all protein-coding genes in a person’s genome to find disease-causing mutations.
- 81479: This code is used for a test called unlisted molecular pathology procedure, which is used for genetic tests that don’t have a specific CPT code.
- 81401: A genetic test using this code checks for particular gene variants in a patient. These differences can alter the pharmaceutical response.
Infectious Disease Testing (CPT codes 87501-87899)
These codes include testing for infectious diseases, including bacterial, viral, and fungal infections.
- 87507 – This code identifies herpes simplex virus and CMV in blood or tissue samples.
- 87505 – This code identifies Chlamydia trachomatis and Neisseria gonorrhoeae in patient samples.
- 87804 – HIV and hepatitis B antibody testing is done using 87804.
- 87491 – This code detects tuberculosis (TB) in a patient’s sample using a skin or blood test.
- 87631 – This code detects the SARS-CoV-2 virus, which produces COVID-19, in patient samples.
- 87116 – This skin or blood test identifies tuberculosis (TB).
Oncology Testing (CPT codes 81479-81599)
These codes are used for testing for genetic mutations and biomarkers associated with various types of cancer.
- 81445: This code detects BRCA1 and BRCA2 gene mutations, which increase breast and ovarian cancer risk.
- 81479: General code for molecular diagnostic tests that detect genetic changes in cancer cells. It tests and treats different cancers.
- 81519: This code tests for KRAS gene mutations, which can help diagnose and treat colorectal cancer.
- 81599: Uncoded molecular diagnostic tests utilize this code. It screens for several cancers.
Pharmacogenomics Testing (CPT codes 81479-81599)
These codes are used for testing genetic variations that affect how an individual responds to certain medications.
81519: CYP450 gene testing uses this code. Genes affect medication metabolism.
Prenatal Testing (CPT codes 81420-81479)
These codes cover various genetic tests performed during pregnancy to assess the risk of certain fetal genetic disorders.
- 81479: This is a general code for unlisted molecular pathology procedures. It may be used for genetic tests not specified by any other CPT code.
- 81405: This code is used for carrier screening tests. Even if a person has no symptoms, carrier screening tests can detect gene mutations that could cause genetic disorders. Carrier screening tests assist family planning decisions.
- 81406: Genetic disease diagnostics utilize this code. Diagnostic testing confirms or rules out fetal genetic disorders. These tests are usually performed if the parents have a genetic condition or a family history of one.
- 81407: This code tests the fetus’s gender. This test is usually done to assess if the fetus is at risk for a sex-linked genetic disease.
- 81408: This code detects fetal aneuploidy. Cells with aneuploidy have aberrant chromosomal numbers. This test checks for Down syndrome and other chromosomal abnormalities.
- 81479: This code is used for other genetic tests not specified by any other CPT code. This code can be used to screen for mutations in genes or unusual genetic disorders.
Hematology and Coagulation Testing (CPT codes 85002-85385)
These codes are used for hemoglobinopathies, bleeding diseases, and thrombophilia testing.
- 85027: Complete Blood Count (CBC) – This test measures blood components such as red blood cells, white blood cells, and platelets.
- 85610: Prothrombin Time (PT) – Blood-thinning drugs like warfarin are monitored with this test, which assesses blood clotting time.
- 85379: D-Dimer – When a blood clot dissolves, a protein fragment is released into the blood, which this test analyzes. It is used to help diagnose blood clots or monitor treatment effectiveness.
- 85302: Fibrinogen – This test examines the blood-clotting protein fibrinogen. Diagnoses and monitors bleeding problems.
- 85025: Complete Blood Count with Differential – This test measures the different types of white blood cells and the other components of a CBC. It can help diagnose infections, inflammation, and leukemia.
Microbiology Testing (CPT codes 87003-87260)
These codes cover microbiology tests such as cultures, antigen detection, and molecular diagnostic tests for infectious diseases.
- 87070: This code is used for billing for bacterial cultures from sources other than urine, blood, or stool. The laboratory will grow and identify the bacteria to determine if an infection is present.
- 87116: This code is used for billing for fungal cultures. The lab will grow and identify fungus to determine infection.
- 87486: This code bills for a molecular diagnostic test identifying HSV DNA or RNA. The lab will amplify viral DNA or RNA to detect it.
- 87507: This code bills for a molecular diagnostic test identifying SARS-CoV-2 (COVID-19) RNA. The lab will amplify viral RNA to detect it.
Conclusion
In conclusion, CPT codes are crucial to medical billing for molecular lab accurate and timely procedures. Knowing the most popular CPT codes for molecular lab procedures can help streamline the billing process and ensure that providers are appropriately compensated. With the proper knowledge and understanding of CPT codes, providers can provide that their billing process is efficient and accurate.