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    v1.0.31
    OpenPayerBilling CodesGenetic Analysis ProceduresCPT cpt-81322-pten-family-specific-mutation-analysis
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    CPT 81322: PTEN Targeted Familial Mutation Analysis

    CPT code 81322 reports the laboratory technical procedure for targeted molecular testing to detect a known familial mutation in the phosphatase and tensin homolog (PTEN) gene; service type: targeted molecular genetic testing, typical site of service: clinical molecular diagnostics laboratory or hospital molecular lab.

    For related coverage guidance, see recent payer policy updates: Minimal Residual Disease (MRD) Testing for Cancer, Biomarker Testing Mandate, Prenatal (Fetal) Diagnostic Testing.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A patient with a known family history of pathogenic PTEN gene variants is referred for targeted molecular testing to determine whether they carry the familial mutation. Typical patients include adult or pediatric family members of a proband previously identified with a PTEN pathogenic or likely pathogenic variant associated with PTEN hamartoma tumor syndrome (including Cowden syndrome) or clinically suggestive features such as multiple hamartomas, macrocephaly, or early-onset breast, thyroid, or endometrial neoplasia. The clinician orders 81322 to perform a targeted laboratory assay that evaluates specifically for the familial PTEN variant rather than comprehensive sequencing.

    Clinical workflow: the ordering clinician documents the family variant and obtains informed consent. A specimen (blood or saliva) is collected at an outpatient laboratory, specialty clinic, or hospital phlebotomy unit. The specimen is sent to a molecular genetics laboratory where a molecular analyst performs targeted testing to detect the specific familial PTEN mutation. Results are returned to the ordering clinician and genetic counselor for interpretation, cascade testing recommendations, and family counseling. Typical site of service: outpatient genetic testing laboratory with specimen collection at outpatient clinics, genetics centers, or hospital outpatient phlebotomy. Service type: targeted familial variant molecular diagnostic testing (technical laboratory service).

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    81162BRCA1 and BRCA2 gene analysis, targeted sequence analysis for known familial variantsOften ordered in parallel when a family history suggests hereditary breast and ovarian cancer syndrome; similar targeted familial variant testing workflow.

    81211 | EGFR (epidermal growth factor receptor) gene analysis, targeted variants | Example of another targeted familial or somatic variant assay; comparable laboratory processes for targeted mutation detection.

    81217 | KRAS gene analysis, targeted variants | Commonly ordered targeted mutation assay in oncology; shares laboratory platforms and reporting practices with PTEN targeted testing.

    0000F is not a standard CPT numeric code and therefore not listed per instructions.

    81225 | RET gene analysis, targeted variants | Used in evaluation of familial medullary thyroid carcinoma syndromes; may be ordered in differential hereditary cancer evaluations where PTEN testing is also considered.

    81479 | Unlisted molecular pathology procedure | Used when an unusual or novel targeted assay lacks a specific code; rarely used if 81322 does not precisely fit the test performed.

    Note: If the laboratory performs full gene sequencing, other CPT codes for comprehensive PTEN analysis exist but are not listed here because 81322 describes targeted familial variant testing. When interpretation is billed separately, report appropriate professional component modifiers and link to relevant physician or genetic counseling services.

    Related Modifiers

    6 rows

    ModifierDescriptionWhen to Use
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    90Modifier ‑90 (Reference/Outside Laboratory) indicates that a laboratory test was performed by an entity other than the treating or reporting provider. The American Medical Association defines…- Use CPT modifier -90 when a laboratory test is performed by an outside/reference laboratory (an entity other than the treating or reporting physician or qualified professional) and the claim needs…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    208D00000X
    207L00000X
    207QS1201X
    207RA0002X
    3336M0003X
    225CX0006X
    310400000X
    207NP0225X

    Related Payer Policy Updates

    Specialty: Genetic & Molecular Testing1 / 3

    10 rows

    PolicyPayerEffective Date
    Minimal Residual Disease (MRD) Testing for Cancerregence2027-01-01
    Biomarker Testing MandateBlue Cross Blue Shield - Rhode Island2027-01-01
    Prenatal (Fetal) Diagnostic TestingBlue Cross Blue Shield - Rhode Island2027-01-01
    Oral Cancer Screening and TestingOscar Health2027-01-01
    RTM Testing for Alpha-1 Antitrypsin DeficiencyOscar Health2027-01-01
    Cytochrome P450 Genotype-Guided Treatment Strategy Corporate Medical Policybcbsvermont2027-01-01
    Polygenic Risk ScoreBlue Cross Blue Shield - Rhode Island2026-12-01
    Gene Expression Profiling for Cutaneous MelanomaBlue Cross Blue Shield - Rhode Island2026-12-01
    Genetic Testing for Macular Degenerationregence2026-11-01
    Pharmacogenetic Panel Testing (for Ohio Only)Colorado Rocky Mountain Health Plans2026-11-01

    Related Codes

    CPT-81105-HPA-1-PLATELET-ANTIGEN-1-GENOTYPING-ITGB3-CD61

    CPT 81105: HPA-1 (ITGB3/CD61) Genotyping, Technical Component

    CPT-81106-HPA-2-T145M-GENETIC-ALLELE-ANALYSIS

    CPT 81106: HPA-2 (T145M) Platelet Antigen Genotyping

    CPT-81107-HPA-3-GENETIC-ANALYSIS-TECHNICAL-COMPONENT

    CPT 81107: HPA‑3 (I843S) Platelet Antigen Genotyping

    CPT-81108-HPA-4-R143Q-GENOTYPING

    CPT 81108: HPA-4 (R143Q) Genotyping

    CPT-81109-HPA-5-K505E-GENETIC-ANALYSIS

    CPT 81109: HPA-5 (K505E) Genotyping Test

    CPT-81110-HPA-6-R489Q-GENOTYPING

    CPT 81110: HPA-6 (R489Q) Genotyping, Technical Component

    CPT-81111-HPA-9-V837M-ALLELE-ANALYSIS

    CPT 81111: HPA-9 (V837M) Genotyping, Technical Test

    CPT-81112-HPA-15-GENETIC-ANALYSIS-S682Y

    CPT 81112: HPA-15 (S682Y) Platelet Antigen Genotyping

    CPT-81120-IDH1-MOLECULAR-DIAGNOSTIC-TEST

    CPT 81120: IDH1 Mutation Detection, Technical Component

    CPT-81121-IDH2-MOLECULAR-DIAGNOSTIC-TEST

    CPT 81121: IDH2 Mutation Detection, Technical Component

    Showing 1–10 of 199

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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