Summary & Overview
CPT 81455: Genomic Sequencing Panel for 51+ Gene Neoplasm Analysis
CPT 81455 represents an advanced genomic sequencing panel for solid organ and hematolymphoid neoplasms that assesses 51 or more genes for sequence variants, copy number changes, rearrangements, and, when performed, isoform or mRNA expression. At a national level, this code reflects the growing clinical adoption of broad sequencing panels in oncology and hematopathology to guide diagnosis, prognosis, and targeted therapy selection. Major commercial payers commonly engaged with this service include Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare. Readers will find a concise overview of the clinical scope and laboratory setting for this procedure, comparisons to related targeted panels, and payer coverage context. The publication provides benchmarks on typical use cases, summarizes relevant clinical indications tied to hematologic and solid tumor diagnoses, and outlines common billing elements such as professional and technical components. It also identifies gaps where data were not provided in the input. This summary is intended to inform laboratory administrators, coding professionals, and policy analysts about the clinical purpose of CPT 81455, payer engagement, and peripheral billing considerations tied to genomic sequencing procedures.
CPT Code Overview
CPT 81455 describes a comprehensive genomic sequencing panel for solid organ or hematolymphoid neoplasms or disorders that evaluates 51 or greater genes. The panel performs genomic sequence analysis to interrogate sequence variants and copy number variants or rearrangements, and may include isoform expression or mRNA expression levels if performed. This procedure falls under Pathology/Laboratory – Genomic Sequencing Procedures and is typically performed in a laboratory setting (POS 81).
Clinical & Coding Specifications
A patient with a diagnosed or suspected hematolymphoid neoplasm (for example chronic myeloid leukemia, acute myeloid leukemia, chronic lymphocytic leukemia, or myelodysplastic disease) undergoes comprehensive genomic sequencing to inform prognosis, targeted therapy selection, or detection of residual disease. A peripheral blood or bone marrow specimen is collected and sent to the laboratory (POS 81). In the laboratory, a molecular pathology team performs a genomic sequence analysis panel interrogating 51 or greater genes for sequence variants and copy number variants, and, if indicated, rearrangements or RNA expression. Results are reported to the treating hematologist/oncologist and incorporated into the patient’s treatment planning and disease monitoring.
Modifier 26 (Professional Component): Use when billing for the professional interpretation and report by a qualified laboratory professional separate from the technical work. Modifier TC (Technical Component): Use when billing for the technical component only (laboratory processing, instrumentation, reagents, and technical staff).
- Associated provider taxonomies:
| Taxonomy Code | Taxonomy Name | Specialty Represented |
|---|---|---|
207ZP0102X | Pathology - Clinical Pathology/Laboratory Medicine | Clinical pathology and laboratory medicine services, including oversight of laboratory testing and interpretation |