How To Use CPT Code 0070U

CPT 0070U describes the analysis of the CYP2D6 gene, specifically looking for common and select rare variants that can affect drug metabolism. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of CPT code 0070U.

1. What is CPT Code 0070U?

CPT 0070U can be used to analyze the CYP2D6 gene for common and select rare variants that may impact the metabolism of certain medications. This code is specifically designed to identify genetic variants that can affect the breakdown of drugs such as tamoxifen, codeine, tramadol, and others metabolized by CYP2D6.

2. Official Description

The official description of CPT code 0070U is: ‘CYP2D6 (cytochrome P450, family 2, subfamily D, polypeptide 6) (eg, drug metabolism) gene analysis, common and select rare variants (ie, *2, *3, *4, *4N, *5, *6, *7, *8, *9, *10, *11, *12, *13, *14A, *14B, *15, *17, *29, *35, *36, *41, *57, *61, *63, *68, *83, *xN).’ This code is used to identify specific genetic variants in the CYP2D6 gene that may impact drug metabolism.

3. Procedure

1. The lab analyst performs all technical steps using a specimen, such as blood, to extract nucleic acids and amplify the quantity of nucleic acid for analysis.
2. The CYP2D6 gene is analyzed for common and select rare variants, including duplications and multiplications of alleles.
3. The target genes are detected and the presence of specific genetic variants is identified.

4. Qualifying circumstances

CPT 0070U is typically ordered for patients who are receiving medications metabolized by CYP2D6, such as tamoxifen, codeine, tramadol, and certain antidepressants and antipsychotics. The purpose is to identify genetic variants that may interfere with the metabolism of these medications. This analysis is not limited to testing for a specific condition, but rather to assess the impact of genetic variants on drug metabolism.

5. When to use CPT code 0070U

CPT code 0070U should be used when there is a need to analyze the CYP2D6 gene for common and select rare variants that can affect drug metabolism. It is appropriate to use this code when ordering a test specifically designed to identify genetic variants in the CYP2D6 gene that may impact the breakdown of medications metabolized by CYP2D6.

6. Documentation requirements

To support a claim for CPT code 0070U, the healthcare provider must document the following information:

• Reason for ordering the test and the specific medications the patient is taking that are metabolized by CYP2D6
• Details of the analysis performed, including the specific genetic variants analyzed
• Date of the test and the laboratory where the analysis was conducted
• Results of the analysis, including the presence or absence of specific genetic variants
• Signature of the healthcare provider ordering the test

7. Billing guidelines

When billing for CPT code 0070U, ensure that the test being performed is the proprietary test developed by the Mayo Clinic Laboratory for analyzing the CYP2D6 gene. Report one unit of this code for a single specimen analyzed on a single date of service. It is important to distinguish this code from other codes for CYP2D6 gene analysis, such as 81226, 0029U, 0071U, 0072U, 0073U, 0074U, 0075U, and 0076U. Do not report this test with any other CPT code.

8. Historical information

CPT code 0070U was added to the Current Procedural Terminology system on October 1, 2018. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient who is taking tamoxifen for breast cancer is ordered a CYP2D6 gene analysis to identify genetic variants that may impact the metabolism of the medication.
2. A patient who is prescribed codeine for pain management undergoes a CYP2D6 gene analysis to assess the impact of genetic variants on the breakdown of the medication.
3. A patient who is taking tramadol for chronic pain is recommended a CYP2D6 gene analysis to determine if genetic variants may affect the metabolism of the drug.
4. A patient who is on an antidepressant medication undergoes a CYP2D6 gene analysis to evaluate the impact of genetic variants on the metabolism of the medication.
5. A patient who is prescribed an antipsychotic medication undergoes a CYP2D6 gene analysis to assess the influence of genetic variants on the breakdown of the drug.
6. A patient who is taking multiple medications metabolized by CYP2D6 is ordered a CYP2D6 gene analysis to identify genetic variants that may impact the metabolism of these medications.
7. A patient who is prescribed a medication that is known to be metabolized by CYP2D6 undergoes a CYP2D6 gene analysis to assess the impact of genetic variants on the breakdown of the drug.
8. A patient who is on a combination of medications, including some metabolized by CYP2D6, is recommended a CYP2D6 gene analysis to determine if genetic variants may affect the metabolism of these medications.
9. A patient who is taking a medication that is known to have a narrow therapeutic index undergoes a CYP2D6 gene analysis to evaluate the impact of genetic variants on the metabolism of the drug.
10. A patient who is prescribed a medication that is known to have potential drug-drug interactions undergoes a CYP2D6 gene analysis to assess the influence of genetic variants on the metabolism of the medication.