Summary & Overview
CPT 81445: Targeted Genomic Sequence Analysis Panel for Solid Organ Neoplasms
CPT code 81445 represents targeted genomic sequence analysis panels for solid organ neoplasms, analyzing DNA across 5 to 50 genes. This laboratory-based molecular pathology service is increasingly important in oncology, supporting precision medicine by identifying genetic mutations that inform diagnosis and treatment strategies for cancer patients. Nationally, the code is recognized by major payers including Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare, reflecting broad coverage and relevance across the healthcare landscape.
This publication provides a comprehensive overview of 81445, including payer coverage, clinical context, and related coding benchmarks. Readers will gain insight into the laboratory service's role in cancer care, typical sites of service, and how it fits within the broader framework of genomic testing. The analysis also highlights associated modifiers, taxonomies, and ICD-10 diagnoses relevant to solid organ neoplasms, as well as related CPT codes that may be used in similar clinical scenarios. Policy updates and coding trends are discussed to inform stakeholders about the evolving landscape of molecular pathology billing and reimbursement.
CPT Code Overview
CPT code 81445 is used for targeted genomic sequence analysis panels focused on solid organ neoplasms. This procedure involves DNA analysis of 5 to 50 genes, providing critical molecular information to guide diagnosis and treatment decisions for patients with solid organ tumors. The service is classified under Laboratory – Genomic Sequencing / Molecular Pathology and is typically performed in a laboratory setting, designated as Place of Service 81. This code is central to advancing precision medicine in oncology, enabling clinicians to identify genetic mutations relevant to cancer care.
Clinical & Coding Specifications
Clinical Context
A patient with a suspected or confirmed solid organ neoplasm, such as lung cancer or mesothelioma, is referred for targeted genomic sequence analysis. The ordering physician, often an oncologist or pulmonologist, requests a laboratory to analyze a tumor sample for DNA variants across a panel of 5–50 genes. The results help guide treatment decisions, such as targeted therapies or eligibility for clinical trials. The laboratory performs the sequencing, and a pathologist or molecular geneticist interprets the findings. The service is typically rendered in a laboratory setting (Place of Service 81), and the report is sent back to the ordering provider for clinical integration.
Coding Specifications
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Modifiers:
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26: Used when billing for the professional component (interpretation and report) of the laboratory service. - Modifier
TC: Used when billing for the technical component (performance of the test) of the laboratory service. - Modifier
59: Used to indicate a distinct procedural service, typically when multiple procedures are performed that are not normally reported together.
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Provider Taxonomies:
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