The laboratory performed targeted next-generation sequencing (NGS) on a buccal swab to assess a patient for cardiovascular health. The test analyzed coding regions for each of the following 37 genes: ACTA2, ACTC1, APOB, CAV3, DSC2, DSG2, DSP, EMD, FBN1, FHL1, FKRP, GLA, HRAS, KCNQ1, LDLR, LMNA, MYBPC3, MYH11, MYH7, MYL2, MYL3, PCSK9, PKP2, PLN, PRKAG2, RAF1, RYR1, RYR2, SCN1B, SCN5A, SLC25A4. TGFBR1, TMEM43, TNNI3, TNNT2, TPM1, TTR. May code 81439 be reported even though only 4 of the 5 minimum required gene examples were tested? Or should these genes be reported using Tier 2 codes because no current CPT NGS code describes this cardiovascular panel? ...

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Note:  The following article synopsis was NOT provided by the AMA. It was created by Find-A-Code/innoviHealth.

Article Overview

This article explains a coding question about a targeted next-generation sequencing test performed on a buccal swab for cardiovascular assessment. It focuses on CPT molecular pathology reporting, including how to think about panel-based testing when the analytes do not align neatly with an existing NGS panel code and when an unlisted code may be considered. The discussion is aimed at coding professionals who need to evaluate laboratory test reporting against current CPT guidance.

Why This Topic Matters

Laboratories and coders frequently encounter genetic test panels that do not fit a single established code description. Understanding the reporting framework for these cases helps support consistent CPT-based claims processing and documentation review.

Codes Discussed

• CPT: 81439
• CPT: 81479

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