Summary & Overview
CPT 81412: Genomic Sequence Analysis Panel for Carrier Testing
CPT code 81412 represents a genomic sequence analysis panel for carrier testing, focusing on inherited disorders such as those commonly found in the Ashkenazi Jewish population. This code is significant nationally as it enables early identification of carrier status for a range of genetic conditions, supporting informed reproductive decisions and clinical management. The procedure involves sequencing at least 9 genes and is performed in specialized laboratory settings.
Major payers covering this service include Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare. The publication provides an overview of payer coverage, clinical context, and policy updates relevant to 81412. Readers will gain insights into benchmarks for laboratory genomic testing, recent changes in payer policies, and the broader clinical implications of carrier screening. The summary also highlights the importance of this code in the context of medical genetics and laboratory procedures, offering a comprehensive look at how genomic sequencing panels are utilized in modern healthcare.
CPT Code Overview
CPT code 81412 is used for genomic sequence analysis panels for carrier testing, specifically targeting disorders prevalent in certain populations, such as Ashkenazi Jewish disorders. This procedure involves sequencing at least 9 genes to identify carrier status for inherited conditions. The service falls under Pathology and Laboratory Procedures – Genomic Sequencing Procedures and Other Molecular Multianalyte Assays. Testing is typically performed in a laboratory setting, designated as Place of Service 81.
Clinical & Coding Specifications
Clinical Context
A patient of Ashkenazi Jewish descent, or with a family history of Ashkenazi Jewish-associated genetic disorders, is referred for carrier testing. The ordering provider, often a specialist in medical genetics, requests a genomic sequence analysis panel to screen for carrier status of at least 9 genes associated with disorders such as Gaucher disease, Tay-Sachs disease, and others. The specimen is collected and sent to a laboratory (Place of Service 81) specializing in molecular genetics. The laboratory performs the sequencing and interprets the results, which are then reported back to the provider for patient counseling and potential family planning decisions.
Coding Specifications
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Modifier
26: Used to indicate the professional component of the service, such as interpretation and reporting by a qualified provider. -
Modifier
59: Used to denote a distinct procedural service, typically when multiple procedures are performed and need to be reported separately.
| Modifier Code | Description |
|---|---|
26 |