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CPT 81419: Genomic Sequence Analysis Panel for Epilepsy
CPT code 81419 represents a laboratory-based genomic sequencing panel that evaluates the genetic sequences of at least 24 specified genes to assist in diagnosing or identifying a genetic predisposition to epilepsy. Nationally, such panels play an increasing role in precision neurology by enabling molecular diagnosis, informing prognosis, and guiding potential therapeutic decision-making for patients with seizure disorders. Payers commonly applying coverage policies for this service include Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare.
This publication provides a concise overview of clinical context for 81419, the typical laboratory service model and site of service, and the relationship of this code to related molecular pathology services. Readers will find summaries of payer coverage patterns and benchmarking where available, a review of relevant clinical applications in epilepsy diagnostics, and comparisons to related molecular and pathology codes. The content highlights how 81419 fits into genomic testing workflows and billing structures used by clinical laboratories and neurology practices. Data not available in the input is noted where applicable.
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Billing Code Overview
CPT code 81419 describes a laboratory-performed genomic sequence analysis panel in which the laboratory analyst conducts the technical testing on a biological specimen (for example, blood) to evaluate genetic sequences of at least the 24 genes listed in the code descriptor. The panel is intended to investigate genetic variants that may help diagnose or indicate a genetic predisposition to epilepsy, a neurological seizure disorder.
Service type: Molecular diagnostic laboratory testing / Genomic sequencing panel
Typical site of service: Clinical laboratory (specimen collection and laboratory processing; specimen may be collected in ambulatory clinics, hospitals, or outpatient phlebotomy sites)
National Reimbursement Benchmarks
Commercial pricing for CPT 81419 centers on BUCA as the average commercial benchmark at $2,356.50, with individual national payers showing notable dispersion. Blue Cross Blue Shield posts the widest interquartile spread (P75–P25 = $1,280.50), reflecting more variability among higher-end contracts, while Aetna is the tightest (P75–P25 = $776.50). UnitedHealth Group and Cigna show intermediate spreads of $1,469.20 and $1,729.40 respectively, indicating broader variability across those networks.
Across payers the median and mean relationships highlight differing skew: Blue Cross Blue Shield and UnitedHealth Group have mean rates above their medians, suggesting higher outliers lift averages, whereas Aetna’s median exceeds its mean slightly. BUCA’s mean at $2,356.50 sits among the higher commercial means, serving as a useful central benchmark for national commercial pricing comparisons.