Code 81162 is a specific Current Procedural Terminology (CPT®) code used in the healthcare system for billing and coding purposes, primarily associated with genetic testing for breast cancer risk.
What is Code 81162?
Code 81162 identifies a CPT® code within the category of BRCA1 and BRCA2 (breast cancer 1 and 2) gene analysis. These genes are well-known for their significant role in inherited susceptibility to breast, ovarian, and other cancers.
CPT codes are a standardized set of medical codes used by healthcare professionals, insurance companies, and government agencies to describe medical, surgical, and diagnostic services. They ensure consistency and accuracy in medical record-keeping and billing across the United States.
Understanding the Significance of 81162
This specific code is crucial for:
- Genetic Testing: It represents services related to the analysis of BRCA1 and BRCA2 genes, which are tumor suppressor genes. Mutations in these genes can significantly increase an individual's lifetime risk of developing certain cancers.
- Accurate Billing: Healthcare providers use CPT® codes like 81162 to accurately report the specific genetic testing procedures performed to insurance companies for reimbursement.
- Standardization: The use of standardized codes like 81162 helps in tracking medical services, managing healthcare data, and ensuring uniform communication across various healthcare entities.
Key Details of Code 81162
The table below summarizes the core information for CPT® Code 81162:
| CPT® Code | Category | Primary Focus |
|---|---|---|
| 81162 | BRCA1, BRCA2 (breast cancer 1 and 2) | Genetic testing for susceptibility to breast cancer |
Detailed information regarding CPT® codes, including their short and long descriptions, guidelines, and specific usage instructions, is available through professional coding resources.
Importance of BRCA1 and BRCA2 Testing
Genetic testing for BRCA1 and BRCA2 is often recommended for individuals with a personal or family history suggestive of a hereditary cancer syndrome. This includes:
- Individuals diagnosed with breast cancer at a young age.
- Those with triple-negative breast cancer.
- Individuals with ovarian, fallopian tube, or primary peritoneal cancer.
- Families with multiple cases of breast, ovarian, pancreatic, or prostate cancer.
- Individuals of Ashkenazi Jewish heritage with a family history of breast or ovarian cancer.
Understanding the results of such genetic tests can guide medical management, including enhanced surveillance, risk-reducing surgeries, and targeted therapies.
For more comprehensive information on CPT® codes and their applications in medical billing, you can refer to professional coding resources such as Find-A-Code.
