Summary & Overview
CPT 81450: Targeted Genomic Sequence Analysis for Hematolymphoid Neoplasms
CPT code 81450 represents targeted genomic sequence analysis panels for hematolymphoid neoplasms, enabling DNA or combined DNA and RNA analysis of 5–50 genes. This molecular diagnostic service is essential for identifying genetic mutations in blood and lymph disorders, supporting clinical decision-making in oncology and hematology. The code is widely recognized by major national payers, including Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare, reflecting its importance in coverage and reimbursement policies.
This publication provides a comprehensive overview of CPT 81450, including payer coverage, clinical context, and related coding information. Readers will gain insights into current policy updates, typical laboratory settings for this service, and its role in precision medicine. The summary also highlights associated modifiers and taxonomies, as well as relevant ICD-10 diagnoses commonly linked to this code. Benchmarks and trends in molecular diagnostics for hematolymphoid neoplasms are discussed, offering a clear understanding of how this code fits into broader pathology and laboratory practices. The information is designed to inform stakeholders about the national landscape for CPT 81450, supporting awareness of clinical and billing considerations.
CPT Code Overview
CPT 81450 is used for targeted genomic sequence analysis panels focused on hematolymphoid neoplasms, such as blood or lymph disorders. This code covers DNA analysis or combined DNA and RNA analysis of panels containing 5–50 genes. The service is classified under Pathology / Laboratory – Molecular Diagnostics and is typically performed in a laboratory setting, most often at Place of Service 81. This testing plays a critical role in the diagnosis and management of hematologic malignancies, supporting precision medicine approaches in oncology.
Clinical & Coding Specifications
Clinical Context
A patient with a suspected or confirmed hematolymphoid neoplasm, such as acute or chronic myelogenous leukemia, presents to their hematologist or oncologist. The clinician orders a targeted genomic sequence analysis panel to evaluate mutations in 5–50 genes relevant to the diagnosis, prognosis, or treatment of the blood or lymph disorder. The specimen is sent to a specialized laboratory (typically Place of Service 81) for molecular diagnostics. The laboratory performs DNA or combined DNA and RNA analysis using CPT code 81450 to identify genetic alterations that may guide therapy or further diagnostic workup. Results are interpreted by a pathologist or molecular geneticist and reported back to the ordering provider for clinical decision-making.
Coding Specifications
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Modifier
26: Used when only the professional component (interpretation of results) is provided by the physician or pathologist. -
Modifier
TC: Used when only the technical component (performance of the laboratory test) is provided by the laboratory.
| Modifier Code | Description |
|---|---|
26 |