Summary & Overview
CPT 81314: Partial PDGFRA Gene Sequence Analysis
CPT code 81314 denotes a technical molecular diagnostic assay that performs a partial gene sequence analysis of the PDGFRA (platelet‑derived growth factor receptor, alpha) gene, focusing on specific regions such as exons 12 and 18 rather than the full gene. This test matters nationally because PDGFRA alterations are actionable biomarkers in certain cancers and other conditions where targeted therapies or diagnostic clarification depend on identifying specific sequence variants. Payers commonly relevant to coverage and reimbursement discussions include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find a concise overview of the clinical context for PDGFRA partial sequencing, how the service is typically delivered in clinical laboratories, and the types of benchmarks and policy considerations that affect payment and utilization at a national level. The publication covers coding specifics for CPT code 81314, typical sites of service, and the clinical scenarios that prompt targeted PDGFRA sequencing. It also summarizes what to expect in payer coverage approaches and highlights areas where policy updates, clinical guideline alignment, and laboratory practice standards influence adoption and billing for this molecular diagnostic service. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 81314 describes a technical laboratory test that performs a partial gene sequence analysis of the PDGFRA (platelet‑derived growth factor receptor, alpha polypeptide) gene. The analysis targets specific portions of the gene rather than sequencing the entire gene; commonly examined regions may include exons 12 and 18. The test is a molecular diagnostic service that identifies sequence variants within the targeted PDGFRA regions that can be relevant for diagnosis, prognosis, or therapeutic selection in conditions where PDGFRA alterations are implicated.
Service type: Molecular diagnostic / genetic sequencing (technical component)
Typical site of service: Clinical laboratory / reference molecular diagnostics laboratory
Clinical & Coding Specifications
Clinical Context
A patient presents with a gastrointestinal stromal tumor (GIST) or suspected GIST based on imaging and biopsy. The treating oncologist or surgical pathologist requests molecular testing of the tumor specimen to identify activating mutations in the platelet-derived growth factor receptor alpha gene. The laboratory performs a targeted partial gene sequence analysis of the PDGFRA gene (commonly including exons such as 12 and 18) to detect clinically actionable mutations that guide targeted therapy selection and prognosis. Typical workflow: the tumor specimen is received in the molecular diagnostics laboratory; DNA is extracted from formalin-fixed, paraffin-embedded tissue or fresh biopsy; targeted PCR amplification and sequencing of specified exons is performed; variants are analyzed and interpreted by a molecular pathologist; a finalized report is delivered to the ordering oncologist who integrates results into treatment planning. Typical site of service: hospital-based molecular diagnostics laboratory or independent reference laboratory. Typical patient scenario: an adult with a biopsy-proven GIST requiring molecular profiling to determine eligibility for tyrosine kinase inhibitor therapy and to inform prognosis and clinical trial enrollment.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 |