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    v1.0.28
    OpenPayerBilling CodesTemporary National Codes (Non-Medicare)HCPCS hcpcs-s3852-apoe-epsilon-4-allele-genetic-test-alzheimers-susceptibility
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    HCPCS S3852: DNA Analysis for APOE ε4 Allele (Alzheimer Susceptibility)

    HCPCS Level II code S3852 describes DNA analysis for the APOE epsilon 4 allele used to assess genetic susceptibility to Alzheimer’s disease; the service is a molecular/genetic diagnostic test typically performed in a clinical laboratory or genetics testing facility and billed as a diagnostic laboratory procedure for clinicians ordering Alzheimer’s risk assessment.

    For related coverage guidance, see recent payer policy updates: Fixed Wing Air Ambulance Transport, Air Ambulance, Ambulance Services (for Tennessee Only).

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    Table of contents

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    • Billing CodesCPT, HCPCS, DRG & more
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    • ModifiersCPT modifiers & usage
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    Clinical & Coding Specifications

    Clinical Context

    A 62-year-old patient with progressive short-term memory decline and a strong family history of Alzheimer disease presents to a neurology clinic. After cognitive screening and neuropsychological testing showing mild cognitive impairment, the neurologist discusses genetic testing for the apolipoprotein E (APOE) genotype to assess susceptibility to Alzheimer disease, specifically testing for the APOE ε4 allele using DNA analysis billed with S3852. A signed informed consent and genetic counseling session are completed by a board-certified genetic counselor or the ordering neurologist before specimen collection. A peripheral blood draw or buccal swab is performed in the outpatient clinic or an accredited laboratory, with the sample sent to a CLIA-certified molecular diagnostics laboratory. Results are returned to the ordering clinician and genetic counselor, documented in the medical record, and used to inform risk discussion, research eligibility, and potential care planning. Typical sites of service include outpatient physician offices, outpatient phlebotomy collection centers, and independent clinical laboratories. Clinical workflow steps: pre-test counseling and consent; specimen collection (blood or buccal swab); laboratory DNA extraction and targeted genotyping for APOE ε4; result reporting and post-test counseling; documentation of results and any subsequent referrals (clinical genetics, neurology follow-up, research enrollment).

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    81002Urinalysis, by dip stick or tablet reagent; without microscopyMay be performed as part of routine baseline labs during the clinic visit prior to specimen collection.
    36415Collection of venous blood by venipunctureCommonly performed for DNA analysis when blood is the chosen specimen for APOE genotyping.
    81225BRCA1 and BRCA2 analysis (for context of targeted genetic testing workflows)Represents a targeted germline DNA analysis CPT; included as an example of molecular test workflow coding—laboratories use analogous molecular methodologies for targeted allele genotyping.
    81479Unlisted molecular pathology procedureUsed by laboratories when no specific CPT exists for a particular molecular test; some laboratories may use this code for specialized APOE genotyping when no specific CPT applies.
    99406Smoking and tobacco use cessation counseling visit, intermediate, greater than 3 minutes up to 10 minutesExample of counseling services that may be billed separately if behavioral risk factor counseling occurs during the visit; counseling codes vary by payer and visit content.

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    56Modifier ‑56 indicates the reporting provider furnished only the preoperative management for a surgical procedure and did not perform the intraoperative or postoperative care. It is used in…- Use Modifier -56 when a provider performs only the preoperative management in a split‑care situation (one physician manages preop care while a different physician performs the intraoperative…
    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…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207RC0000XCardiovascular Disease PhysicianAn internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threaten…
    207QG0300XGeriatric Medicine (Family Medicine) PhysicianA family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitati…
    2080P0202XPediatric Cardiology PhysicianA pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and…
    363L00000XNurse Practitioner(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision mak…
    367A00000XAdvanced Practice MidwifeAdvanced practice midwifery encompasses the independent provision of care during pregnancy, childbirth, and the postpartum period; sexual and reproduc…
    163WI0500XInfusion Therapy Registered NurseNursing Service Providers · Registered Nurse
    207VX0201XGynecologic Oncology PhysicianAn obstetrician/gynecologist who provides consultation and comprehensive management of patients with gynecologic cancer, including those diagnostic an…
    207LC0200XCritical Care Medicine (Anesthesiology) PhysicianAn anesthesiologist, who specializes in critical care medicine diagnoses, treats and supports patients with multiple organ dysfunction. This specialis…

    Related ICD-10-CM Codes

    26 rows

    ICD-10-CM CodeDescription
    F02.80Dementia in other diseases classified elsewhere, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
    F03.90Unspecified dementia, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
    F06.8Other specified mental disorders due to known physiological condition
    F10.27Alcohol dependence with alcohol-induced persisting dementia
    F19.97Other psychoactive substance use, unspecified with psychoactive substance-induced persisting dementia
    G30.0Alzheimer's disease with early onset
    G30.1Alzheimer's disease with late onset
    G30.8Other Alzheimer's disease
    G30.9Alzheimer's disease, unspecified
    G31.1Senile degeneration of brain, not elsewhere classified

    Showing 1–10 of 26

    Related Payer Policy Updates

    Specialty: Emergency & Medical Transportation1 / 3

    9 rows

    PolicyPayerEffective Date
    Fixed Wing Air Ambulance TransportCigna2026-08-15
    Air AmbulanceAmbetter Georgia2026-08-01
    Ambulance Services (for Tennessee Only)UnitedHealthcare2026-08-01
    Ambulance Services (for New Mexico Only)UnitedHealthcare2026-08-01
    Clinical Policy: Air AmbulanceArizona Complete Health2026-08-01
    Clinical Policy: Air AmbulanceCentene2026-08-01
    Air AmbulanceCentene2026-08-01
    Clinical Policy: Air AmbulanceAmbetter Nevada2026-08-01
    Ambulance TransportProvidence Health Plan2026-07-01

    Related Codes

    HCPCS-LEVEL-II-S2152-SOLID-ORGAN-TRANSPLANTATION-GLOBAL-CARE

    HCPCS Level II S2152: Solid Organ Procurement and Transplantation

    HCPCS-LEVEL-II-S2266-INDUCED-ABORTION-29-TO-31-WEEKS

    HCPCS Level II S2266: Induced Abortion, 29 to 31 Weeks

    HCPCS-LEVEL-II-S3630-EOSINOPHIL-COUNT-BLOOD-DIRECT

    HCPCS Level II S3630: Eosinophil Count, Blood, Direct

    HCPCS-LEVEL-II-S4017-INCOMPLETE-ART-CYCLE-CANCELLED-PRIOR-TO-STIMULATION

    HCPCS Level II S4017: Incomplete Cycle — Cancelled Prior to Stimulation

    HCPCS-LEVEL-II-S8055-ULTRASOUND-GUIDANCE-MULTIFETAL-REDUCTION-TC

    HCPCS Level II S8055: Ultrasound Guidance for Multifetal Pregnancy Reduction

    HCPCS-LEVEL-II-S8940-EQUESTRIAN-HIPPOTHERAPY-PER-SESSION

    HCPCS Level II S8940: Equestrian/Hippotherapy, Per Session

    HCPCS-LEVEL-II-S9024-PARANASAL-SINUS-ULTRASOUND

    HCPCS Level II S9024: Paranasal Sinus Ultrasound

    HCPCS-LEVEL-II-S9366-HOME-TPN-1-2L-PER-DAY-HOME-INFUSION

    HCPCS Level II S9366: Home Infusion TPN, 1–2 L/day

    HCPCS-LEVEL-II-S9446-GROUP-PATIENT-EDUCATION-NON-PHYSICIAN

    HCPCS S9446: Patient Education, Non-Physician Provider, Group, Per Session

    HCPCS-LEVEL-II-S9451-EXERCISE-CLASS-NON-PHYSICIAN-SESSION

    HCPCS S9451: Exercise Classes, Non-Physician Provider, Per Session

    Showing 1–10 of 532

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    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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