Question

question 19

a patients mother and sister have been treated for breast cancer. she has blood drawn for cancer gene analysis with molecular pathology testing. she has previously received genetic counseling. blood will be tested for full sequence analysis and common duplication or deletion variants (mutations) in brca1, brca2 (breast cancer 1 and 2). what cpt® code(s) is (are) reported for this molecular pathology procedure?

81162
81163, 81164
81206
81200

Explanation:

Identify the clinical procedure and target genes

The patient is undergoing molecular pathology testing for breast cancer gene analysis. Specifically, the test is for full sequence analysis and common duplication or deletion variants (mutations) in both BRCA1 and BRCA2 genes.

Evaluate CPT code descriptions for BRCA1 and BRCA2 testing

• CPT code 81162 represents: BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis and full duplication/deletion analysis (ie, detection of large gene rearrangements).
• CPT code 81163 represents: BRCA1, BRCA2 gene analysis; full sequence analysis.
• CPT code 81164 represents: BRCA1, BRCA2 gene analysis; full duplication/deletion analysis.
• CPT code 81206 represents: BCR/ABL1 gene analysis.
• CPT code 81200 represents: ASPA gene analysis.

Select the correct CPT code

Since the test performed includes both full sequence analysis AND common duplication/deletion variants for both BRCA1 and BRCA2, the single combined code 81162 is the most appropriate and specific code to report.

Answer:

• (A) 81162 (Correct answer)
• (B) 81163, 81164
• (C) 81206
• (D) 81200