Billing & Coding: Proposed New Molecular Pathology Crosswalk Codes for 2018
The newly proposed 2018 Clinical Laboratory Fee Schedule includes over 130 crosswalked CPT codes, including roughly 30 new codes for molecular pathology tests. New Crosswalked Molecular Pathology Codes in 2018 Clinical Laboratory Fee Schedule Test Crosswalked To 81105 (81X15): Human Platelet Antigen 1 genotyping (HPA-1), ITGB3 (integrin, beta 3 [platelet glycoprotein IIIa], antigen CD61 [GPIIIa]) […]
The newly proposed 2018 Clinical Laboratory Fee Schedule includes over 130 crosswalked CPT
codes, including roughly 30 new codes for molecular pathology tests.
New Crosswalked Molecular Pathology Codes in 2018 Clinical Laboratory Fee Schedule
| Test | Crosswalked To |
| 81105 (81X15): Human Platelet Antigen 1 genotyping (HPA-1), ITGB3 (integrin, beta 3 [platelet glycoprotein IIIa], antigen CD61 [GPIIIa]) (e.g., neonatal alloimmune thrombocytopenia [NAIT], post-transfusion purpura) gene analysis, common variant, HPA-1a/b (L33P) | 81227 (CYP2c9 (cytochrome p450, family 2, subfamily C, polypeptide 9) (e.g., drug metabolism)) |
| 81106 (81X16): Human Platelet Antigen 2 genotyping (HPA-2), GP1BA (glycoprotein Ib [platelet], alpha polypeptide [GPIba]) (e.g., neonatal alloimmune thrombocytopenia [NAIT], post-transfusion purpura) gene analysis, common variant, HPA-2a/b (T145M) | 81227 (see above for descriptor) |
| 81107 (81X17): Human Platelet Antigen 3 genotyping (HPA-3), ITGA2B (integrin, alpha 2b [platelet glycoprotein IIb of IIb/IIIa complex], antigen CD41 [GPIIb]) (e.g., neonatal alloimmune thrombocytopenia [NAIT], post-transfusion purpura) gene analysis, common variant, HPA-3a/b (I843S) | 81227 (see above for descriptor) |
| 81108 (81X18): Human Platelet Antigen 4 genotyping (HPA-4), ITGB3 (integrin, beta 3 [platelet glycoprotein IIIa], antigen CD61 [GPIIIa]) (e.g., neonatal alloimmune thrombocytopenia [NAIT], post-transfusion purpura) gene analysis, common variant, HPA-4a/b (R143Q) | 81227 (see above for descriptor) |
| 81109 (81X19): Human Platelet Antigen 5 genotyping (HPA-5), ITGA2 (integrin, alpha 2 [CD49B, alpha 2 subunit of VLA-2 receptor] [GPIa]) (e.g., neonatal alloimmune thrombocytopenia [NAIT], post-transfusion purpura) gene analysis, common variant (e.g., HPA-5a/b (K505E)) | 81227 (see above for descriptor) |
| 81110 (81X20): Human Platelet Antigen 6 genotyping (HPA-6w), ITGB3 (integrin, beta 3 [platelet glycoprotein IIIa, antigen CD61] [GPIIIa]) (e.g., neonatal alloimmune thrombocytopenia [NAIT], post-transfusion purpura) gene analysis, common variant, HPA-6a/b (R489Q) | 81227 (see above for descriptor) |
| 81111 (81X21): Human Platelet Antigen 9 genotyping (HPA-9w), ITGA2B (integrin, alpha 2b [platelet glycoprotein IIb of IIb/IIIa complex, antigen CD41] [GPIIb]) (e.g., neonatal alloimmune thrombocytopenia [NAIT], posttransfusion purpura) gene analysis, common variant, HPA-9a/b (V837M) | 81227 (see above for descriptor) |
| 81112 (81X22): Human Platelet Antigen 15 genotyping (HPA-15), CD109 (CD109 molecule) (e.g., neonatal alloimmune thrombocytopenia [NAIT], posttransfusion purpura) gene analysis, common variant, HPA-15a/b (S682Y) | 81227 (see above for descriptor) |
| 81120 (81X23): IDH1 (isocitrate dehydrogenase 1 [NADP+], soluble) (e.g., glioma), common variants (e.g., R132H, R132C) | 81227 (see above for descriptor) |
| 81121 (81X24): IDH2 (isocitrate dehydrogenase 2 [NADP+], mitochondrial) (e.g., glioma), common variants (e.g., R140W, R172M) | 81227 (see above for descriptor) |
| 81175 (81X04): ASXL1 (additional sex combs like 1, transcriptional regulator) (e.g., myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia) gene analysis; full gene sequence | 81295 (MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (e.g., hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis) |
| 81176 (81X05):ASXL1 (additional sex combs like 1, transcriptional regulator) (e.g., myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia) gene analysis; targeted sequence analysis (e.g., exon 12) | 81272 (KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) (e.g., gastrointestinal stromal tumor [GIST], acute myeloid leukemia, melanoma), gene analysis, targeted sequence analysis (e.g., exons 8, 11, 13, 17, 18)) |
| 81230 (81X30): CYP3A4 (cytochrome P450 family 3 subfamily A member 4) (e.g., drug metabolism) gene analysis, common variant(s) (e.g., *2, *22) | 81227 (see above for descriptor) |
| 81231 (81X31): CYP3A5 (cytochrome P450 family 3 subfamily A member 5) (e.g., drug metabolism) gene analysis, common variants (e.g., *2, *3, *4, *5 *6, *7) | 81227 (see above for descriptor) |
| 81232 (81X32): DPYD (dihydropyrimidine dehydrogenase) (e.g., 5-fluorouracil/5-FU and capecitabine drug metabolism) gene analysis, common variant(s) (e.g., *2A, *4, *5, *6) | 81227 (see above for descriptor) |
| 81238 (81X25): F9 (coagulation factor IX) (e.g., hemophilia B) full gene sequence | 81295 (see above for descriptor) |
| 81247 (81X37): G6PD (glucose-6-phosphate dehydrogenase) (e.g., hemolytic anemia, jaundice) gene analysis; common variant(s) (e.g., A, A-) | 81227 (see above for descriptor) |
| 81248 (81X38): G6PD (glucose-6-phosphate dehydrogenase) (e.g., hemolytic anemia, jaundice) gene analysis; known familial variant(s) | 81215 (BRCA1 (breast cancer 1) (e.g., hereditary breast and ovarian cancer) gene analysis; known familial variant) |
| 81249 (81X40): G6PD (glucose-6-phosphate dehydrogenase) (e.g., hemolytic anemia, jaundice) gene analysis; full gene sequence | 81295 (see above for descriptor) |
| 81258 (81X58): HBA1/HBA2 (alpha globin 1 and alpha globin 2) (e.g., alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; known familial variant | 81322 (PTEN (phosphatase and tensin homolog) (e.g., Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; known familial variant) |
| 81259 (81X59): HBA1/HBA2 (alpha globin 1 and alpha globin 2) (e.g., alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; full gene sequence | 81295 (see above for descriptor) |
| 81269 (81X69): HBA1/HBA2 (alpha globin 1 and alpha globin 2) (e.g., alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; duplication/deletion variants | 81294 (MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (e.g., hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; duplication/deletion variants) |
| 81283 (81X33): IFNL3 (interferon, lambda 3) (e.g., drug response) gene analysis, rs12979860 variant | 81322 (see above for descriptor) |
| 81328 (81X34): SLCO1B1 (solute carrier organic anion transporter family, member 1B1) (e.g., adverse drug reaction) gene analysis, common variant(s) (e.g., *5) | 81227 (see above for descriptor) |
| 81334 (813XX): RUNX1 (runt related transcription factor 1) (e.g., acute myeloid leukemia, familial platelet disorder with associated myeloid malignancy) gene analysis, targeted sequence analysis (e.g., exons 3-8) | 81272 (see above for descriptor) |
| 81335 (81X35): TPMT (thiopurine S-methyltransferase) (e.g., drug metabolism) gene analysis, common variants (e.g., *2, *3) | 81227 (see above for descriptor) |
| 81346 (81X36): TYMS (thymidylate synthetase) (e.g., 5-fluorouracil/5-FU drug metabolism) gene analysis, common variant(s) (e.g., tandem repeat variant) | 81227 (see above for descriptor) |
| 81361 (813X1): HBB (hemoglobin, subunit beta) (e.g., sickle cell anemia, beta thalassemia, hemoglobinopathy); common variant(s) (e.g., HbS, HbC, HbE) | 81227 (see above for descriptor) |
| 81362 (813X2): HBB (hemoglobin, subunit beta) (e.g., sickle cell anemia, beta thalassemia, hemoglobinopathy); known familial variant(s) | 81322 (see above for descriptor) |
| 81363 (813X3): HBB (hemoglobin, subunit beta) (e.g., sickle cell anemia, beta thalassemia, hemoglobinopathy); duplication/deletion variant(s) | 81294 (see above for descriptor) |
| 81364 (813X4): HBB (hemoglobin, subunit beta) (e.g., sickle cell anemia, beta thalassemia, hemoglobinopathy); full gene sequence | 81295 (see above for descriptor) |
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