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CPT 81414: Cardiac Ion Channelopathy CNV Panel
CPT code 81414 covers laboratory panel testing that detects genetic duplications and deletions in at least two genes linked to cardiac ion channelopathies — inherited disorders that disrupt the heart's electrical signaling and can lead to arrhythmias. This genomic copy-number variant panel is clinically significant for genetic diagnosis of conditions such as long QT syndrome and related channelopathies, informing risk assessment and family cascade testing. Nationally, such molecular diagnostics are increasingly integrated into cardiology workflows and specialty diagnostic labs.
The analysis addresses coverage and policy considerations for major national payers: Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of payer coverage patterns, coding context, clinical indications commonly associated with the test, and how this code relates to other genomic testing codes used for cardiac channelopathy evaluation. The publication summarizes service setting expectations, typical clinical scenarios that prompt testing, and comparisons to adjacent genomic panels that include sequencing of larger gene sets.
This resource is intended for clinical laboratory administrators, billing and compliance staff, and clinicians who order hereditary arrhythmia testing. It provides practical context on CPT code 81414, typical use cases, and where it fits within the broader genomic testing landscape for inherited cardiac electrical disorders.
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Billing Code Overview
CPT code 81414 describes a laboratory genetic test panel that evaluates a patient specimen for genetic duplications and deletions of at least two genes associated with cardiac ion channelopathies, disorders of membrane proteins that affect the heart's electrical system. The assay is focused on detecting copy-number variants (duplications and deletions) in genes that contribute to conditions such as long QT syndrome and other inherited arrhythmias.
Service Type: Laboratory genetic testing; copy-number variant (CNV) panel for cardiac ion channelopathy genes.
Typical Site of Service: Clinical laboratory or pathology service, with specimen collection occurring in outpatient clinics, specialty cardiology offices, or hospital outpatient phlebotomy settings.
National Reimbursement Benchmarks
National commercial reimbursement for CPT 81414 centers on a BUCA (average commercial) rate of $592.30, with payer-specific means clustering above and below that mark. Blue Cross Blue Shield’s mean of $676 and Cigna’s mean of $605.20 sit near BUCA, while Aetna’s mean of $417.50 and UnitedHealth Group’s mean of $503 are lower. Blue Cross Blue Shield and Cigna display high upper tails, with maximums of $2345.50 and $1901.60 respectively, whereas Aetna’s maximum is comparatively modest at $758.
Dispersion measured by the interquartile range (P75–P25) highlights variability: Blue Cross Blue Shield’s IQR is $260.00 (from $472.70 to $756.70), Cigna’s IQR is $447.70 (from $343.90 to $786.60), UnitedHealth Group’s IQR is $321.60 (from $256.30 to $584.90), BUCA’s IQR is $287.00 (from $380.70 to $694.70), and Aetna’s IQR is $300.40 (from $266.00 to $526.40). Cigna shows the widest IQR at $447.70, indicating the greatest middle-50% spread, while Blue Cross Blue Shield’s narrower IQR at $284.00 indicates the tightest middle-range among the listed payers.