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    v1.0.30
    OpenPayerBilling CodesMultianalyte Assays with Algorithmic AnalysesCPT cpt-81525-colon-cancer-12-gene-rt-pcr-recurrence-score
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    CPT 81525: 12-Gene RT-PCR Colon Tumor Recurrence Score

    CPT code 81525 describes a laboratory service for performing real-time reverse transcription polymerase chain reaction (RT–PCR) analysis of 12 genes on colon tumor tissue and applying an algorithmic analysis of the assay results with patient data to generate a recurrence score; service type: molecular diagnostic testing with algorithmic/analytics component; typical site of service: clinical molecular laboratory or pathology laboratory performing tumor tissue testing.

    For related coverage guidance, see recent payer policy updates: Oral Cancer Screening and Testing, RTM Testing for Alpha-1 Antitrypsin Deficiency, Cytochrome P450 Genotype-Guided Treatment Strategy Corporate Medical Policy.

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    Clinical & Coding Specifications

    Clinical Context

    A 62-year-old patient with recently resected stage II–III colon adenocarcinoma has formalin-fixed paraffin-embedded (FFPE) tumor tissue submitted to a molecular pathology laboratory. The laboratory analyst receives the tissue block or unstained slides, extracts RNA, and performs real-time reverse transcription polymerase chain reaction (RT–PCR) targeting a 12-gene panel validated for colon cancer recurrence risk. The analyst runs technical assays, performs quality control, and uses an algorithm integrating the assay results with relevant clinical data (for example, tumor stage and sample quality) to generate a patient-specific recurrence score. The laboratory issues a report to the ordering oncologist and the surgical team to inform adjuvant therapy decision-making. Typical site of service is an independent clinical molecular laboratory or hospital-based molecular pathology lab; specimen collection and surgery occur in an ambulatory surgical center or hospital inpatient/outpatient surgical setting.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    88305Level IV surgical pathology, gross and microscopic examinationPerformed on tumor specimen to establish diagnosis before molecular testing
    88342Immunohistochemistry, each antibody (single stain)May be performed on the same tissue block as part of ancillary workup prior to molecular testing
    81599Unlisted molecular pathology procedureUsed when a specific test does not have a dedicated CPT code (billing alternative when appropriate)
    83912Molecular pathology procedure; interpretation and report onlyUsed when an independent professional component interpretation of molecular data is billed separately
    81275KRAS gene analysis (example)Other molecular tests commonly ordered in colorectal cancer workup alongside recurrence assays

    Related Modifiers

    5 rows

    ModifierDescriptionWhen to Use
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    90Modifier ‑90 (Reference/Outside Laboratory) indicates that a laboratory test was performed by an entity other than the treating or reporting provider. The American Medical Association defines…- Use CPT modifier -90 when a laboratory test is performed by an outside/reference laboratory (an entity other than the treating or reporting physician or qualified professional) and the claim needs…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    33Modifier 33 was created by the American Medical Association in response to the Affordable Care Act to identify services provided for preventive intent. It is appended to CPT/HCPCS codes that could be…- Use modifier -33 when a CPT/HCPCS service that can be billed as either preventive or diagnostic/treatment is provided with preventive intent and aligns with USPSTF A or B recommendations or other…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207RH0000X
    363L00000X
    207V00000X
    101YM0800X
    286500000X
    2080P0203X
    1223P0700X
    207U00000X

    Related ICD-10-CM Codes

    28 rows

    ICD-10-CM CodeDescription
    C18.0Malignant neoplasm of cecum
    C18.2Malignant neoplasm of ascending colon
    C18.3Malignant neoplasm of hepatic flexure
    C18.4Malignant neoplasm of transverse colon
    C18.5Malignant neoplasm of splenic flexure
    C18.6Malignant neoplasm of descending colon
    C18.7Malignant neoplasm of sigmoid colon
    C18.8Malignant neoplasm of overlapping sites of colon
    C18.9Malignant neoplasm of colon, unspecified
    C19Malignant neoplasm of rectosigmoid junction

    Showing 1–10 of 28

    Related Payer Policy Updates

    Specialty: Genetic & Molecular Testing1 / 3

    10 rows

    PolicyPayerEffective Date
    Oral Cancer Screening and TestingOscar Health2027-01-01
    RTM Testing for Alpha-1 Antitrypsin DeficiencyOscar Health2027-01-01
    Cytochrome P450 Genotype-Guided Treatment Strategy Corporate Medical Policybcbsvermont2027-01-01
    Carrier Testing Panels for Genetic Diseases (for Kentucky Only)UnitedHealthcare2026-10-01
    Genetic Testing for Neurological Disorders (for Kansas Only)UnitedHealthcare2026-10-01
    Genetic and Molecular TestingProvidence Health Plan2026-10-01
    Cell-Free Fetal DNA Testing (for Idaho Only)UnitedHealthcare2026-10-01
    Next Generation Sequencing for Minimal Residual Disease DetectionProvidence Health Plan2026-10-01
    Pharmacogenetic Panel Testing (for Kansas Only)UnitedHealthcare2026-10-01
    Non-Covered Genetic Panel TestsProvidence Health Plan2026-10-01

    Related Codes

    CPT-81490-RA-DISEASE-ACTIVITY-SCORE-SERUM-BIOMARKER-PANEL

    CPT 81490: Serum Biomarker Panel and RA Disease Activity Score

    CPT-81493-CORONARY-ARTERY-DISEASE-23-GENE-RT-PCR-RISK-SCORE

    CPT 81493: 23-Gene RT-PCR Molecular Test With CAD Risk Score

    CPT-81500-CA125-HE4-ALGORITHMIC-RISK-SCORE

    CPT 81500: Algorithmic Risk Score Using CA-125 and HE4

    CPT-81503-ALGORITHMIC-LAB-RISK-SCORE-CA125-APOLIPOPROTEIN-A1

    CPT 81503: Algorithmic Risk Score from Multiple Lab Markers

    CPT-81504-TUMOR-ORIGIN-RNA-EXPRESSION-CLASSIFIER

    CPT 81504: Tumor RNA Expression Profile Comparison

    CPT-81506-DIABETES-BIOMARKER-PANEL-WITH-RISK-SCORE

    CPT 81506: Diabetes Risk Score from Biochemical Assays

    CPT-81507-NIPS-CELL-FREE-DNA-TRISOMY-RISK-ANALYSIS

    CPT 81507: Noninvasive Prenatal Testing for Trisomies 13, 18, 21

    CPT-81508-PAPP-A-HCG-ALGORITHMIC-RISK-ASSAY

    CPT 81508: First-Trimester PAPP-A and hCG Risk Score

    CPT-81509-LAB-ALGORITHMIC-RISK-ASSESSMENT-PAPP-A-HCG-DIA

    CPT 81509: Prenatal Biochemical Risk Score from PAPP–A, hCG, DIA

    CPT-81510-PRENATAL-TRIPLE-MARKER-ALGORITHMIC-RISK-ASSESSMENT

    CPT 81510: Prenatal Serum Screening with Algorithmic Risk Score

    Showing 1–10 of 41

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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