Find policies, billing codes, payers, states, and providers
CPT 81412: Ashkenazi Jewish Multi-Gene Genomic Sequence Panel
CPT code 81412 covers a targeted genomic sequencing panel that analyzes at least nine genes associated with hereditary disorders concentrated in individuals of Ashkenazi Jewish descent. This code matters nationally as precision genetic testing expands clinical care, carrier screening, and diagnostic workups for inherited conditions with population‑specific prevalence. Payers use such coding to determine coverage, prior‑authorization requirements, and clinical criteria for multi‑gene panels.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Readers will find a concise overview of clinical context and test purpose, guidance on typical sites of service and laboratory workflows, and comparisons to related genetic test codes used for larger panels. The publication outlines common billing considerations, typical ICD‑10 clinical indications associated with disorders screened by this panel, and how 81412 differs from broader genomic panels that require sequencing of more genes.
This summary is intended for clinicians, laboratory administrators, and billing professionals seeking clear, national‑level context on the clinical role of this code, payer coverage landscape, and where it fits among related genetic testing codes and diagnostic pathways.
Customize your policy alerts
Sign up for cpt 81412 policy alerts
Get alerted when payer policies referencing 81412 are released or updated.
Monitor payer policy activity
Billing Code Overview
CPT code 81412 describes a genomic sequence analysis panel that evaluates a patient specimen for genetic sequences of at least nine genes associated with disorders clustered in people of Ashkenazi Jewish descent. This is a laboratory molecular diagnostic service focused on targeted multi‑gene sequencing to detect pathogenic variants linked to inherited conditions prevalent in that population.
Service type: Genomic sequence analysis panel (targeted multi‑gene sequencing)
Typical site of service: Clinical molecular diagnostics laboratory or reference genetic testing laboratory
National Reimbursement Benchmarks
National commercial rates for CPT 81412 center on a BUCA average of $2,129.20 as a benchmark for aggregated commercial contracts. Blue Cross Blue Shield shows the highest dispersion with an interquartile range (P75–P25) of $1,107.00 ($2,861.80 − $1,754.80), indicating wider variability across contract rates. Cigna also exhibits substantial spread with an IQR of $1,749.40 ($2,986.70 − $1,237.30), while UnitedHealth Group’s IQR is $1,201.10 ($2,229.50 − $1,028.40). Aetna is the tightest among these payers with an IQR of $1,428.00 ($1,983.00 − $508.00), though its minimum of $0 suggests outliers.
Comparatively, BUCA’s commercial average sits near the higher-middle of payer means at $2,129.20, providing a useful cross-payer reference point. Blue Cross Blue Shield’s large max of $6,904.90 and Cigna’s max of $7,345.40 further highlight upper-tail variability that contributes to broader market dispersion, while UnitedHealth Group and Aetna show more moderate upper ranges relative to those peaks.