Pathology/Lab Coding Alert

Question: We’re providing an NRAS molecular test that yields results for multiple variants under exon 2, exon 3, and exon 4. The descriptor for 81311 only mentions variants for exons 2 and 3. Should we also bill 81479 for the variants under exon 4?

Washington Subscriber

Answer: No, you should not bill 81479 (Unlisted molecular pathology procedure) in addition to 81311 (NRAS (neuroblastoma RAS viral [v-ras] oncogene homolog) (eg, colorectal carcinoma), gene analysis, variants in exon 2 (eg, codons 12 and 13) and exon 3 (eg, codon 61)) for the NRAS test you describe.

According to the CPT^® instructions for the molecular pathology section 81105-81479, “Codes that describe tests to assess for the presence of gene variants use common gene variant names. Typically, all of the listed variants would be tested. However, these lists are not exclusive. If other variants are also tested in the analysis, they would be included in the procedure and not reported separately.”

Based on that instruction, you would report 81311 for the NRAS gene analysis even if you test for additional variants beyond exon 2 and exon 3.

Tip: CPT^® often provides more than one code for a specific gene, with each code representing a different group of variants. You need to ensure that you’re reporting the most specific code that describes the variants you’re testing.