Summary & Overview
CPT 81176: Targeted ASXL1 Gene Analysis, Technical Laboratory Service
CPT code 81176 represents a laboratory technical procedure for targeted genetic analysis, such as sequencing or mutation testing of exon 12 of the ASXL1 transcriptional regulator gene. This code captures the laboratory’s technical work to generate sequence data and identify variants in specified gene regions. Nationally, targeted gene testing is integral to precision oncology, hematology diagnostics, and hereditary disease evaluation because it informs diagnosis, prognosis, and therapeutic decisions.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and the laboratory service represented by the code, typical sites of service, common payer coverage considerations, and the set of commonly reported modifiers. The publication outlines benchmarking and policy-relevant topics including coverage policies, documentation expectations, and coding hygiene relevant to targeted molecular testing. Where specific input fields were not provided, the text notes that data are not available in the input.
This summary is intended for laboratory billing managers, coding professionals, and policy analysts seeking a national-level briefing on the clinical meaning and payer landscape associated with CPT code 81176.
Billing Code Overview
CPT code 81176 describes a technical laboratory procedure in which a lab analyst performs targeted genetic analysis of specific exons — for example, exon 12 of the ASXL1 transcriptional regulator gene. This service involves processing and analyzing patient specimens to detect sequence variants in targeted genes.
Service type: Genetic molecular diagnostic testing (technical component).
Typical site of service: Clinical molecular diagnostics laboratory or hospital laboratory performing targeted gene sequencing or mutation analysis.
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient with persistent cytopenias and a history of unexplained anemia and thrombocytopenia is evaluated in a hematology clinic. Peripheral blood and bone marrow testing identify morphologic features concerning for a myeloid neoplasm such as myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML). The treating hematologist orders targeted molecular testing for somatic mutations in genes associated with myeloid malignancies. The clinical laboratory performs a technical molecular assay analyzing targeted exons of the ASXL1 gene (for example, exon 12) to detect pathogenic variants that inform diagnosis, prognosis, and potential therapeutic decisions.
The clinical workflow: the clinician collects a venous blood or bone marrow specimen and sends it to a reference molecular pathology laboratory. The laboratory accessioning team logs the specimen, the molecular technologist performs DNA extraction, PCR or NGS library preparation targeting ASXL1 exon(s), runs sequencing or variant analysis, and the bioinformatics team filters and interprets variants. A molecular pathologist reviews the technical report and issues a clinical report back to the ordering provider. Typical turnaround time ranges from several days to two weeks depending on testing complexity.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the professional interpretation/reporting by a physician-laboratory director separate from the technical lab work |