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    v1.0.30
    OpenPayerBilling CodesGenomic Sequencing Procedures and Other Molecular Multianalyte AssaysCPT cpt-81412-ashkenazi-jewish-genomic-sequence-panel
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    CPT 81412: Ashkenazi Jewish–Associated Genetic Sequence Panel

    Commercial payers pay $2129 on average nationally for this procedure.

    CPT code 81412 describes a genomic sequence analysis panel performed on a patient specimen to evaluate genetic sequences of at least nine genes associated with disorders clustered in people of Ashkenazi Jewish descent; this service is a targeted hereditary genetic testing panel typically performed as a laboratory service in a clinical molecular genetics or reference laboratory setting and involves sequencing and analysis of multiple genes relevant to Ashkenazi Jewish–associated inherited disorders.

    For related coverage guidance, see recent payer policy updates: Oral Cancer Screening and Testing, RTM Testing for Alpha-1 Antitrypsin Deficiency, Cytochrome P450 Genotype-Guided Treatment Strategy Corporate Medical Policy.

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    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.

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Clinical & Coding Specifications

    Clinical Context

    A 28-year-old Ashkenazi Jewish woman with a family history of Tay‑Sachs disease and prior carrier screening in relatives presents for carrier testing prior to conception. Her obstetrician refers her to a genetic counselor. After pretest counseling, a peripheral blood sample is collected and sent to a molecular diagnostics laboratory for a targeted genomic sequence analysis panel that evaluates pathogenic variants in at least nine genes associated with disorders enriched in the Ashkenazi Jewish population. Results are analyzed by a laboratory analyst or molecular geneticist, with interpretation documented in the laboratory report and returned to the ordering clinician and genetic counselor for post‑test counseling and reproductive planning. Typical workflow steps: sample collection and accessioning, DNA extraction, library preparation and sequencing, bioinformatic analysis, variant classification, report generation, and result disclosure to the ordering clinician.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    81443Genomic sequence analysis panel for severe inherited conditions; must include sequencing of at least 15 genes (used for broader panels)Alternative code for larger multi‑gene panels; use 81412 when testing is limited to Ashkenazi Jewish‑associated disorders (≥9 genes as specified).

    Related Modifiers

    7 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…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    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…
    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…
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    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…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207SG0201X
    207SG0202X
    207SG0203X
    207SG0205X
    385HR2055X
    163WX0003X
    207PT0002X
    213EP0504X

    Related ICD-10-CM Codes

    31 rows

    ICD-10-CM CodeDescription
    D56.1Beta thalassemia
    E74.21Galactosemia
    E75.02Tay-Sachs disease
    E75.22Gaucher disease
    E75.242Niemann-Pick disease type C
    E76.01Hurler's syndrome
    E76.02Hurler-Scheie syndrome
    E76.03Scheie's syndrome
    E76.04
    E78.5Hyperlipidemia, unspecified

    Showing 1–10 of 31

    Related Payer Policy Updates

    Specialty: Genetic & Molecular Testing1 / 3

    10 rows

    PolicyPayerEffective Date
    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
    Carrier Testing Panels for Genetic Diseases (for Kentucky Only)UnitedHealthcare2026-10-01
    Genetic Testing for Neurological Disorders (for Kansas Only)UnitedHealthcare2026-10-01
    Genetic and Molecular TestingProvidence Health Plan2026-10-01
    Cell-Free Fetal DNA Testing (for Idaho Only)UnitedHealthcare2026-10-01
    Next Generation Sequencing for Minimal Residual Disease DetectionProvidence Health Plan2026-10-01
    Pharmacogenetic Panel Testing (for Kansas Only)UnitedHealthcare2026-10-01
    Non-Covered Genetic Panel TestsProvidence Health Plan2026-10-01

    Related Codes

    CPT-81410-GENOMIC-PANEL-AORTIC-DISEASE

    CPT 81410: Heritable Thoracic Aortic Disease Targeted Gene Panel

    CPT-81411-GENETIC-DUPLICATION-DELETION-PANEL-AORTIC-DISEASE

    CPT 81411: Genetic Panel for Aortic Dysfunction Copy Number Analysis

    CPT-81413-GENOMIC-PANEL-CARDIAC-ION-CHANNELOPATHIES

    CPT 81413: Cardiac Ion Channelopathy Targeted Gene Panel

    CPT-81414-CARDIAC-ION-CHANNELOPATHY-CNV-PANEL

    CPT 81414: Cardiac Ion Channelopathy Copy Number Variant Panel

    CPT-81415-EXOME-SEQUENCE-ANALYSIS-UNEXPLAINED-DISORDER

    CPT 81415: Exome Sequence Analysis for Unexplained Disorder

    CPT-81416-FAMILIAL-EXOME-SEQUENCE-ANALYSIS

    CPT 81416: Relative Exome Sequence Analysis for Reference Exome

    CPT-81417-EXOME-SEQUENCE-REEVALUATION

    CPT 81417: Exome Reanalysis for New Clinical Information

    CPT-81418-PHARMACOGENOMIC-MULTIGENE-DRUG-METABOLISM-PANEL

    CPT 81418: Pharmacogenetic Multigene Panel Including CYP2C19 and CYP2D6

    CPT-81419-GENOMIC-SEQUENCE-PANEL-EPILEPSY

    CPT 81419: Genomic Sequence Analysis Panel for Epilepsy

    CPT-81420-NIPS-FETAL-ANEUPLOIDY-SEQUENCING-PANEL

    CPT 81420: Cell-Free Fetal DNA Panel for Chromosomes 13, 18, 21

    Showing 1–10 of 43

    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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