Summary & Overview
CPT 81429: Genomic Sequence Analysis Panel for Solid Organ Neoplasms
CPT code 81429 is a critical billing code for advanced genomic testing in oncology, specifically for solid organ neoplasms. This code covers DNA analysis panels that examine 51 or more genes, enabling clinicians to obtain detailed genetic information about tumors. Such comprehensive testing is increasingly important in cancer care, as it informs targeted therapies and personalized treatment plans. The code is most commonly billed by independent laboratories specializing in molecular pathology.
Blue Cross Blue Shield is a key payer for this service, reflecting broad national coverage and relevance. Readers will gain insight into clinical indications for the test, typical billing practices, and policy updates affecting reimbursement. The publication also provides benchmarks for utilization and highlights related codes for targeted panels and immunohistochemistry procedures. Understanding CPT code 81429 is essential for stakeholders in laboratory medicine, oncology, and healthcare administration, as it represents a cornerstone of precision medicine in cancer diagnostics.
CPT Code Overview
CPT code 81429 represents a genomic sequence analysis panel for solid organ neoplasms, specifically DNA analysis involving 51 or greater genes. This procedure is classified under Pathology and Laboratory services and is typically performed in an Independent Laboratory setting (Place of Service 81). The test is used to provide comprehensive genetic profiling of solid organ tumors, supporting clinical decision-making in oncology.
Clinical & Coding Specifications
Clinical Context
A patient diagnosed with a solid organ malignancy, such as lung, breast, colon, prostate, or pancreatic cancer, is referred for advanced molecular testing. The treating oncologist requests a comprehensive genomic sequence analysis panel to identify mutations across 51 or more genes in the tumor DNA. The specimen, typically a biopsy or surgical tissue sample, is sent to an independent laboratory (Place of Service 81). The laboratory performs the genomic sequencing to guide targeted therapy, prognosis, or further diagnostic evaluation. Results are interpreted by a pathologist specializing in molecular genetic pathology, and a report is sent back to the ordering physician for clinical decision-making.
Coding Specifications
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Modifiers:
- Modifier
26: Used when reporting only the professional component (interpretation and report) of the genomic sequence analysis. - Modifier
TC: Used when reporting only the technical component (performance of the sequencing procedure).
- Modifier
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Provider Taxonomies:
Taxonomy Code Specialty Name 207ZP0102XPathology - Clinical Pathology/Laboratory Medicine 207ZP0105XPathology - Molecular Genetic Pathology 207L00000XAnatomic Pathology
These taxonomies represent providers specializing in laboratory medicine, molecular genetic pathology, and anatomic pathology, all of whom may be involved in ordering, performing, or interpreting the genomic sequence analysis panel.
Related Diagnoses
C34.90: Malignant neoplasm of unspecified part of unspecified bronchus or lung- Relevant for patients with lung cancer undergoing genomic analysis to identify actionable mutations.
C50.919: Malignant neoplasm of unspecified site of unspecified female breast- Used for breast cancer cases where comprehensive genomic profiling may inform targeted therapy.
C18.9: Malignant neoplasm of colon, unspecified- Applied to colon cancer patients to guide personalized treatment based on genetic alterations.
C61: Malignant neoplasm of prostate- For prostate cancer, genomic sequencing can reveal mutations relevant to prognosis and therapy.
C25.9: Malignant neoplasm of pancreas, unspecified- Pancreatic cancer patients may benefit from broad genomic analysis to identify potential therapeutic targets.
Related CPT Codes
81445: Targeted genomic sequence analysis panel, solid organ neoplasm, 5-50 genes- Used for smaller panels; may be selected instead of
81429when fewer genes are analyzed.
- Used for smaller panels; may be selected instead of
88342: Immunohistochemistry, per specimen; initial single antibody stain procedure- Often performed alongside genomic sequencing to assess protein expression in tumor tissue.
88341: Immunohistochemistry, per specimen; each additional single antibody stain procedure- Used for additional antibody stains beyond the initial, commonly in conjunction with
88342.
- Used for additional antibody stains beyond the initial, commonly in conjunction with
88360: Morphometric analysis, tumor immunohistochemistry (e.g., HER-2/neu), quantitative or semiquantitative- Provides quantitative assessment of specific tumor markers, which may complement genomic analysis.
Codes 88342, 88341, and 88360 are frequently used together in the diagnostic workflow for solid organ neoplasms, while 81445 is an alternative to 81429 for smaller gene panels.
National Reimbursement Benchmarks
National mean rates for CPT code 81429 are identical between Blue Cross Blue Shield and BUCA (average commercial), both at $80.02. Medicare rates are not available in the input for comparison.
Rate dispersion is minimal across both commercial payers, with the 25th, 50th, and 75th percentiles all at $80.00. This indicates a very tight range, with no variation between the lower and upper quartiles for these payers.
The table and chart below present the full breakdown of national mean rates and percentile values for each payer.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.