Summary & Overview
CPT 81340: T‑Cell Receptor Beta (TCRB) Clonality Assay
CPT code 81340 represents a molecular pathology test that detects clonal T‑cell populations by amplifying and analyzing the T‑cell antigen receptor beta (TCRB / TRB@) locus. This assay is clinically important for the diagnosis and monitoring of T‑cell leukemias and lymphomas, where identification of clonal T‑cell expansions can inform diagnosis and guide further hematopathology workups. Nationally, such molecular clonality testing is an integral part of hematologic malignancy diagnostics and increasingly utilized as molecular techniques expand in clinical practice.
Key payers covered in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical purpose of the code, the typical laboratory setting and specimen context, and what to expect in payer coverage discussions. The publication summarizes common reimbursement considerations, coding relationships, and clinical context relevant to laboratories and billing teams. Where available, benchmarks and policy updates are summarized to help stakeholders understand utilization trends and coverage dynamics for molecular clonality testing. Data not available in the input will be noted clearly in relevant sections.
Billing Code Overview
CPT code 81340 describes a laboratory molecular diagnostic assay that uses amplification methods to detect abnormal clonal T‑cell populations from the T‑cell antigen receptor beta locus (TCRB / TRB@). This test identifies clonal T‑cell populations that may be indicative of certain leukemias and lymphomas.
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Service type: Molecular pathology / laboratory diagnostic testing involving nucleic acid amplification and clonal analysis.
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Typical site of service: Clinical molecular laboratory or hospital-based pathology laboratory; specimens are typically derived from peripheral blood, bone marrow, or lymphoid tissue and processed in a specialized lab setting.
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Clinical & Coding Specifications
Clinical Context
A 62-year-old patient with persistent lymphadenopathy and unexplained cytopenias is referred to hematology after abnormal peripheral smear and flow cytometry suggest a T‑cell lymphoproliferative disorder. The clinician orders molecular testing to detect clonality of the T‑cell receptor beta (TCRB / TRB@) gene using PCR-based amplification and fragment analysis or NGS-based assays. A peripheral blood sample or bone marrow aspirate is collected in appropriate tube types and sent to a clinical molecular laboratory. The laboratory technologist performs nucleic acid extraction, amplification targeting TCRB gene rearrangements, and analysis to determine presence of an abnormal clonal T‑cell population that may support a diagnosis of T‑cell leukemia or lymphoma. Results are reviewed by a pathologist or molecular laboratory director for interpretation and a report is issued to the ordering hematologist/oncologist for integration with morphology, immunophenotyping, and clinical data.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the physician interpretation/reporting portion if the lab and physician bill separately. |
TC | Technical component |