CPT^® 81243, Under Genetic Analysis Procedures

The Current Procedural Terminology (CPT^®) code 81243 as maintained by American Medical Association, is a medical procedural code under the range - Genetic Analysis Procedures.

Additional/Related Information

Tabs

Summary

The lab analyst performs the technical lab test to detect the presence of changes in the gene for fragile X messenger ribonucleoprotein 1, also known as FMR1, typically to detect common abnormal forms involving expanded sequences.

For clinical responsibility, terminology, tips and additional info
start codify free trial.

View any code changes for 2024 as well as historical information on code creation and revision.

Crosswalks

Tabs

Combat the #1 denial reason - mismatched CPT-ICD-9 codes - with top Medicare carrier and private payer accepted diagnoses for the chosen CPT® code.

View the CPT® code's corresponding procedural code and DRG. In a click, check the DRG's IPPS allowable, length of stay, and more. To plug inpatient facility revenue drains, subscribe to DRG Coder today.

Crosswalk to an anesthesia code and its base units, and calculate payments in a snap! Subscribe to Anesthesia Coder today.

View matching HCPCS Level II codes and their definitions.

Forum

Have a question about CPT Code 81243 ? Start a discussion here

Genetic testing procedures: what is the reason for CPT 81243 denial as incidental when billed with CPT 81420?

What is the reason for CPT 81243 denial as incidental when billed with CPT 81420?... [ Read More ]

Pricing lab components for panels

Our office now uses lab corp for some panels but we pay lab corp a fee rather than them billing patients. The fee for this needs to be added to the pricing on our end. My question is do I enter the fe... [ Read More ]

59 modifier 59 modifier 81229 81243 laboratory billing

I work for a genetic testing laboratory, we currently bill CPT 81229 (CMA) and 81243 (Fragile-X) together and we have always billed these with a 59 modifier on the 81243 with great success. Recently,... [ Read More ]

View All