Summary & Overview
CPT 81446: Genomic Sequence Analysis Panel for Solid Organ Neoplasms
CPT code 81446 represents a genomic sequence analysis panel for solid organ neoplasms, focusing on DNA analysis of 5 to 50 genes. This code is significant in the national landscape as it supports precision medicine approaches in oncology, enabling clinicians to identify genetic mutations that may influence treatment decisions for various cancers. The procedure is categorized under Pathology and Laboratory services and is most commonly performed in independent laboratory settings.
Blue Cross Blue Shield is a key payer covering this code, reflecting its importance in commercial insurance reimbursement for advanced molecular diagnostics. Readers will gain insights into clinical benchmarks, policy updates, and the broader context of genomic testing in cancer care. The publication also addresses relevant modifiers, associated taxonomies, ICD-10 diagnoses for common cancer types, and related CPT codes, providing a comprehensive overview for stakeholders involved in laboratory billing, coding, and policy analysis. This summary is intended for a national audience, highlighting the role of 81446 in advancing personalized oncology and laboratory medicine.
CPT Code Overview
CPT code 81446 is used for genomic sequence analysis panels targeting solid organ neoplasms, specifically DNA analysis of 5 to 50 genes. This procedure falls under the Pathology and Laboratory service type and is typically performed in an Independent Laboratory setting (Place of Service 81). The test is designed to provide comprehensive genetic information that can inform diagnosis and treatment strategies for patients with solid organ tumors.
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 genomic sequence analysis panel to identify DNA mutations across 5-50 genes relevant to the neoplasm. The specimen, typically a tissue biopsy from the affected organ, is sent to an independent laboratory (Place of Service 81) specializing in pathology and molecular diagnostics. The laboratory performs the genomic sequencing to guide targeted therapy decisions and inform prognosis. Results are interpreted by a pathologist or molecular oncologist and reported back to the treating physician for integration into the patient's care plan.
Coding Specifications
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Modifiers:
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26: Indicates the professional component, used when the physician interprets the results but does not perform the technical aspects of the test. - Modifier
TC: Indicates the technical component, used when the laboratory performs the test but does not provide interpretation.
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Provider Taxonomies:
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