Summary & Overview
CPT 81192: NTRK2 Translocation Analysis in Solid Tumors
CPT code 81192 represents a technical laboratory assay for detecting NTRK2 translocations in specimens such as formalin-fixed paraffin-embedded tissue. These molecular tests identify gene rearrangements that can activate tropomyosin receptor kinase (TRK) pathways and are clinically relevant for diagnosing and characterizing certain solid tumors where TRK-driven proliferation may guide therapeutic selection. Nationally, precision oncology testing like this influences treatment decisions and coverage policy discussions given its potential impact on targeted therapy eligibility.
Key payers covered in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines how CPT code 81192 is used in clinical workflows, where samples are processed, and common billing contexts.
Readers will learn the clinical context for NTRK2 fusion testing, typical sites of service, the scope of services captured under the code, and what to expect in payer coverage and billing practice summaries. The report also provides benchmarks on utilization patterns, coding considerations, and recent policy updates impacting molecular diagnostic testing. Data not available in the input for specific payer policies, taxonomies, ICD-10 pairings, and related codes are noted where applicable.
Billing Code Overview
CPT code 81192 describes a laboratory technical procedure that analyzes NTRK2 (neurotrophic receptor tyrosine kinase 2) translocations in specimens such as formalin-fixed paraffin-embedded tissue (FFPE). The test identifies NTRK2 rearrangements that may drive tropomyosin receptor kinase (TRK)–mediated cell proliferation in certain solid tumors.
-
Service type: Molecular pathology / laboratory diagnostic test for gene fusion detection
-
Typical site of service: Hospital-based or independent clinical laboratory with pathology and molecular diagnostics capability
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient with a recently resected metastatic colorectal adenocarcinoma presents for oncologic molecular profiling to guide targeted therapy. The pathology laboratory receives a formalin-fixed paraffin-embedded (FFPE) tumor block from the surgical pathology department. The laboratory technologist prepares the specimen and the molecular diagnostics laboratory performs targeted next-generation sequencing (NGS) or RNA-based testing to identify NTRK2 gene rearrangements that can produce TRK fusion proteins. Results are reported to the treating oncologist and incorporated into tumor board discussion to determine eligibility for TRK inhibitor therapy. The typical workflow includes specimen accessioning, nucleic acid extraction from FFPE tissue, library preparation and sequencing or fusion assay, bioinformatics analysis, and a molecular pathologist’s interpretive report. Typical site of service: hospital-based molecular pathology laboratory or independent reference laboratory. Service type: molecular diagnostic laboratory service analyzing NTRK2 translocations from FFPE tumor tissue.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When reporting the interpretive (pathologist/molecular pathologist) component separate from the technical lab work. |
TC |