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CPT 81504: RNA Expression Tumor Origin Classifier
CPT code 81504 represents an RNA expression–based molecular diagnostic assay that matches a tumor’s transcriptional profile to a reference database to infer likely tissue of origin for cancers of unknown primary. The test is used nationally to help guide diagnostic workups and therapy selection when the primary tumor site is uncertain. Its clinical value lies in narrowing diagnostic possibilities and informing downstream management.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical purpose and typical sites of service, payer coverage context, and implications for laboratory service lines. The publication highlights common billing and coding considerations for laboratories and health plans, and summarizes available policy elements and benchmarking topics relevant to molecular diagnostic oncology testing.
This summary provides practical context for clinicians, laboratory managers, and payers evaluating the role of an RNA expression–based tumor origin classifier in diagnostic pathways, without state-specific policy details. Data not available in the input are explicitly noted where applicable in supporting sections.
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Billing Code Overview
CPT code 81504 describes a molecular diagnostic test that compares the RNA expression profile of a tumor of unknown primary origin to a reference tumor database to identify the most likely tissue or site of origin. This service type is a molecular diagnostic tumor origin classifier that analyzes tumor RNA expression patterns.
Typical site of service: clinical laboratory or specialized molecular diagnostics laboratory. The test is performed on tumor tissue specimens and reported by laboratories that provide advanced genomic and transcriptomic profiling.