CPT 81227: CYP2C9 Genetic Test for Drug Metabolism
CPT code 81227 denotes a molecular diagnostic laboratory assay to detect common variants in the CYP2C9 gene, a key enzyme in drug metabolism. Nationally, reporting and coverage of pharmacogenomic tests such as this are important for medication safety and personalized therapy decisions, particularly for drugs with narrow therapeutic indices or dose adjustments affected by CYP2C9 variants.
Key payers in typical analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Coverage policies and prior authorization requirements for pharmacogenomic testing vary by payer, affecting access and utilization.
Readers will find a concise clinical context for the test, an overview of service settings and typical use cases, and a summary of the payer landscape covered in this analysis. Benchmarks and policy trends relevant to molecular diagnostic and pharmacogenomic services are summarized, along with operational considerations for laboratories submitting claims for CPT code 81227. Data not available in the input are noted where applicable.
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Billing Code Overview
CPT code 81227 describes a laboratory test performed by a lab analyst to detect the presence of common variants in the gene cytochrome P450, family 2, subfamily C, polypeptide 9 (CYP2C9). This is a molecular diagnostic assay that identifies genetic changes affecting drug metabolism.
Service Type: Genetic testing — molecular diagnostic assay
Typical Site of Service: Clinical laboratory or reference laboratory
Data not available in the input for payers, taxonomies, ICD-10 diagnoses, and related codes.