Summary & Overview
CPT 81429: Genomic Sequence Analysis Panel for Solid Organ Neoplasms
CPT code 81429 is a critical billing code for advanced genomic testing in oncology, specifically for solid organ neoplasms. This code covers DNA analysis panels that examine 51 or more genes, enabling clinicians to obtain detailed genetic information about tumors. Such comprehensive testing is increasingly important in cancer care, as it informs targeted therapies and personalized treatment plans. The code is most commonly billed by independent laboratories specializing in molecular pathology.
Blue Cross Blue Shield is a key payer for this service, reflecting broad national coverage and relevance. Readers will gain insight into clinical indications for the test, typical billing practices, and policy updates affecting reimbursement. The publication also provides benchmarks for utilization and highlights related codes for targeted panels and immunohistochemistry procedures. Understanding CPT code 81429 is essential for stakeholders in laboratory medicine, oncology, and healthcare administration, as it represents a cornerstone of precision medicine in cancer diagnostics.
CPT Code Overview
CPT code 81429 represents a genomic sequence analysis panel for solid organ neoplasms, specifically DNA analysis involving 51 or greater genes. This procedure is classified under Pathology and Laboratory services and is typically performed in an Independent Laboratory setting (Place of Service 81). The test is used to provide comprehensive genetic profiling of solid organ tumors, supporting clinical decision-making in oncology.
Clinical & Coding Specifications
Clinical Context
A patient diagnosed with a solid organ malignancy, such as lung, breast, colon, prostate, or pancreatic cancer, is referred for advanced molecular testing. The treating oncologist requests a comprehensive genomic sequence analysis panel to identify mutations across 51 or more genes in the tumor DNA. The specimen, typically a biopsy or surgical tissue sample, is sent to an independent laboratory (Place of Service 81). The laboratory performs the genomic sequencing to guide targeted therapy, prognosis, or further diagnostic evaluation. Results are interpreted by a pathologist specializing in molecular genetic pathology, and a report is sent back to the ordering physician for clinical decision-making.
Coding Specifications
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Modifiers:
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26: Used when reporting only the professional component (interpretation and report) of the genomic sequence analysis. - Modifier
TC: Used when reporting only the technical component (performance of the sequencing procedure).
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Provider Taxonomies:
Taxonomy Code Specialty Name