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CPT 81552: 15-Gene mRNA Expression Profiling for Uveal Melanoma Risk
CPT code 81552 represents a molecular diagnostic assay that performs mRNA expression profiling of 15 genes and uses an algorithmic analysis with patient data to generate a metastasis risk score for uveal melanoma. This test is clinically significant because it stratifies patients by metastatic risk, informing prognosis and potential surveillance strategies. As precision oncology services become more common, national coverage and payment policies for genomic risk assays are increasingly relevant to laboratories, oncologists, and payers.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication summarizes payer coverage patterns, coding and billing considerations, and relevant clinical context for uveal melanoma molecular prognostics. Readers will find benchmarks for utilization and reimbursement where available, summaries of policy language and coverage criteria, and a concise clinical description of the test’s role in risk stratification. The report also highlights typical sites of service and operational considerations for labs offering the assay.
Data not available in the input includes specific coverage policies, reimbursement rates, associated taxonomies, and ICD-10 diagnosis mappings. The content is presented for a national audience and focuses on the clinical and billing identity of CPT code 81552, plus what stakeholders need to know about payer engagement and coding use.
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Billing Code Overview
CPT code 81552 describes a laboratory service that performs mRNA gene expression profiling for 15 genes and applies an algorithmic analysis combining patient data and lab results to report a risk score for uveal melanoma metastasis. The service type is molecular diagnostic testing with algorithmic/analytics interpretation. The typical site of service is a clinical molecular diagnostics laboratory or reference lab performing high-complexity testing.