evekhm/cms_iom_500 huggingface dataset:
Draft Article - Billing and Coding: Genetic Testing for Oncology (DA59125)
81404Ampullary Adenocarcinoma, Extrahepatic Cholangiocarcinoma, Intrahepatic Cholangiocarcinoma, Gallbladder Cancer, Erdheim-Chester Disease, Langerhans Cell Histiocytosis, Rosai-Dorfman Disease, Multiple Endocrine Neoplasia, Type 2B, Neuroendocrine and Adrenal Tumors -Pheochromocytoma/Paraganglioma, Pancreatic Adenocarcinoma, Medullary Thyroid CancerSDHC (succinate dehydrogenase complex, subunit C, integral membrane protein, 15kDa) (e.g., hereditary paraganglioma-pheochromocytoma syndrome), duplication/deletion analysis81404Neuroendocrine and Adrenal Tumors -Pheochromocytoma/Paraganglioma, Soft Tissue Sarcoma - Carney-Stratakis Syndrome (Gastric Gastrointestinal Stromal Tumor and Paraganglioma), Hereditary Renal Cell CarcinomaSDHD (succinate dehydrogenase complex, subunit D, integral membrane protein) (e.g., hereditary paraganglioma), full gene sequence81404Neuroendocrine and Adrenal Tumors - Pheochromocytoma/Paraganglioma, Soft Tissue Sarcoma - Carney-Stratakis syndrome (Gastric Gastrointestinal Stromal Tumor and Paraganglioma),Hereditary Renal Cell CarcinomaSTK11 (serine/threonine kinase 11) (e.g., Peutz-Jeghers syndrome), duplication/deletion analysis81404Ampullary Adenocarcinoma, Pancreatic Adenocarcinoma, Hereditary Cancer Testing Criteria: Breast Cancer, Ovarian Cancer, Pancreatic Cancer, and Peutz-Jeghers SyndromeVHL (von Hippel-Lindau tumor suppressor) (e.g., von Hippel-Lindau familial cancer syndrome), full gene sequence81404
Draft Article - Billing and Coding: Genetic Testing for Oncology (DA59125)
VHL (von Hippel-Lindau tumor suppressor) (e.g., von Hippel-Lindau familial cancer syndrome), full gene sequence81404Central Nervous System Cancers - Primary Spinal Cord Tumors, Malignant Peritoneal Mesothelioma, Malignant Pleural Mesothelioma, Neuroendocrine Tumors of the Pancreas (Well-Differentiated Grade 1/2), Neuroendocrine and Adrenal Tumors -Pheochromocytoma/Paraganglioma, Neuroendocrine and Adrenal Tumors - Well-Differentiated Grade 3 Neuroendocrine Tumors, Von Hippel-Lindau Syndrome, Hereditary Renal Cell CarcinomaZEB2 (zinc finger E-box binding homeobox 2) (e.g., Mowat-Wilson syndrome), duplication/deletion analysis81404Acute Myeloid Leukemia - Blastic Plasmacytoid Dendritic Cell Neoplasm (BPDCN)FH (fumarate hydratase) (e.g., fumarate hydratase deficiency, hereditary leiomyomatosis with renal cell cancer), full gene sequence81405Hereditary Renal Cell CarcinomaKRAS (Kirsten rat sarcoma viral oncogene homolog) (e.g., Noonan syndrome), full gene sequence81405Ampullary Adenocarcinoma, Chronic Myeloid Leukemia, Colon Cancer, Rectal Cancer, Erdheim-Chester Disease, Langerhans Cell Histiocytosis, Rosai-Dorfman Disease, Myelodysplastic Syndromes, Myeloproliferative Neoplasms, Non-Small Cell Lung Cancer, Pancreatic Adenocarcinoma, Soft Tissue Sarcoma - Embryonal Rhabdomyosarcoma, Juvenile Myelomonocytic LeukemiaMEN1 (multiple endocrine neoplasia I) (e.g., multiple endocrine neoplasia type 1, Wermer syndrome), full gene sequence81405
Draft Article - Billing and Coding: Genetic Testing for Oncology (DA59125)
MEN1 (multiple endocrine neoplasia I) (e.g., multiple endocrine neoplasia type 1, Wermer syndrome), full gene sequence81405Adrenal Gland Tumors, Multiple Endocrine Neoplasia, Type 1, Neuroendocrine Tumors of the Gastrointestinal Tract (Well-Differentiated Grade 1/2), Neuroendocrine and Adrenal Tumors -Lung and Thymus, Neuroendocrine Tumors of the Pancreas (Well-Differentiated Grade 1/2), Neuroendocrine and Adrenal Tumors - Well-Differentiated Grade 3 Neuroendocrine TumorsNF2 (neurofibromin 2 [merlin]) (e.g., neurofibromatosis, type 2), duplication/deletion analysis81405Malignant Peritoneal Mesothelioma, Malignant Pleural MesotheliomaRET (ret proto-oncogene) (e.g., multiple endocrine neoplasia, type 2A and familial medullary thyroid carcinoma), targeted sequence analysis (e.g., exons 10, 11, 13-16)81405Ampullary Adenocarcinoma, Extrahepatic Cholangiocarcinoma, Intrahepatic Cholangiocarcinoma, Gallbladder Cancer, Erdheim-Chester Disease, Langerhans Cell Histiocytosis, Rosai-Dorfman Disease, Multiple Endocrine Neoplasia, Type 2A, Neuroendocrine and Adrenal Tumors -Pheochromocytoma/Paraganglioma, Pancreatic Adenocarcinoma, Medullary Thyroid CancerRPS19 (ribosomal protein S19) (e.g., Diamond-Blackfan anemia), full gene sequence81405Myelodysplastic SyndromesSDHB (succinate dehydrogenase complex, subunit B, iron sulfur) (e.g., hereditary paraganglioma), full gene sequence81405
Draft Article - Billing and Coding: Genetic Testing for Oncology (DA59125)
81405Myelodysplastic SyndromesSDHB (succinate dehydrogenase complex, subunit B, iron sulfur) (e.g., hereditary paraganglioma), full gene sequence81405Gastrointestinal Stromal Tumors (GIST),Neuroendocrine and Adrenal Tumors - Pheochromocytoma/Paraganglioma, Soft Tissue Sarcoma - Carney-Stratakis syndrome (Gastric GIST and Paraganglioma), Hereditary Renal Cell CarcinomaSDHC (succinate dehydrogenase complex, subunit C, integral membrane protein, 15kDa) (e.g., hereditary paraganglioma-pheochromocytoma syndrome), full gene sequence81405Neuroendocrine and Adrenal Tumors - Pheochromocytoma/Paraganglioma, Soft Tissue Sarcoma - Carney-Stratakis Syndrome (Gastric Gastrointestinal Stromal Tumor and Paraganglioma), Hereditary Renal Cell CarcinomaSMAD4 (SMAD family member 4) (e.g., hemorrhagic telangiectasia syndrome, juvenile polyposis), duplication/deletion analysis81405Hereditary Cancer Testing Criteria: Juvenile Polyposis SyndromeSTAT3 (signal transducer and activator of transcription 3 [acute-phase response factor]) (e.g., autosomal dominant hyper-IgE syndrome), targeted sequence analysis (e.g., exons 12, 13, 14, 16, 17, 20, 21)81405Myelodysplastic Syndromes, T-Cell Lymphomas - Hepatosplenic T-Cell Lymphoma, T-Cell Lymphomas - T-Cell Large Granular Lymphocytic LeukemiaSTK11 (serine/threonine kinase 11) (e.g., Peutz-Jeghers syndrome), full gene sequence81405Ampullary Adenocarcinoma, Pancreatic Adenocarcinoma, Hereditary Cancer Testing Criteria: Breast Cancer, Ovarian Cancer, Pancreatic Cancer, and Peutz-Jeghers Syndrome
Draft Article - Billing and Coding: Genetic Testing for Oncology (DA59125)
81405Ampullary Adenocarcinoma, Pancreatic Adenocarcinoma, Hereditary Cancer Testing Criteria: Breast Cancer, Ovarian Cancer, Pancreatic Cancer, and Peutz-Jeghers SyndromeTSC1 (tuberous sclerosis 1) (e.g., tuberous sclerosis), duplication/deletion analysis81405Neuroendocrine Tumors of the Pancreas (Well-Differentiated Grade 1/2),Neuroendocrine and Adrenal Tumors - Well-Differentiated Grade 3 Neuroendocrine Tumors, Uterine Sarcoma, Encapsulated Glioma, Hereditary Renal Cell CarcinomaWT1 (Wilms tumor 1) (e.g., Denys-Drash syndrome, familial Wilms tumor), full gene sequence81405Chronic Myeloid Leukemia, Malignant Peritoneal Mesothelioma, Malignant Pleural Mesothelioma, Myelodysplastic Syndromes, Wilms Tumor (Nephroblastoma), Acute Myeloid LeukemiaZEB2 (zinc finger E-box binding homeobox 2) (e.g., Mowat-Wilson syndrome), full gene sequence81405Acute Myeloid Leukemia - Blastic Plasmacytoid Dendritic Cell Neoplasm (BPDCN)BRAF (B-Raf proto-oncogene, serine/threonine kinase) (e.g., Noonan syndrome), full gene sequence81406Ampullary Adenocarcinoma,B-Cell Lymphomas - Splenic Marginal Zone Lymphoma, Adult Gliomas, Chronic Myeloid Leukemia, Gastrointestinal Stromal Tumors (GIST), Extrahepatic Cholangiocarcinoma, Intrahepatic Cholangiocarcinoma, Gallbladder Cancer, Erdheim-Chester Disease, Langerhans Cell Histiocytosis, Rosai-Dorfman Disease, Pancreatic AdenocarcinomaBTK (Bruton agammaglobulinemia tyrosine kinase) (e.g., X-linked agammaglobulinemia), full gene sequence81406
Draft Article - Billing and Coding: Genetic Testing for Oncology (DA59125)
BTK (Bruton agammaglobulinemia tyrosine kinase) (e.g., X-linked agammaglobulinemia), full gene sequence81406Chronic Lymphocytic Leukemia/Small Lymphocytic LymphomaCDH1 (cadherin 1, type 1, E-cadherin [epithelial]) (e.g., hereditary diffuse gastric cancer), full gene sequence81406Gastric Cancer, Hereditary Cancer Testing Criteria: Breast Cancer and Ovarian CancerMAP2K1 (mitogen-activated protein kinase 1) (e.g., cardiofaciocutaneous syndrome), full gene sequence81406Erdheim-Chester Disease, Langerhans Cell Histiocytosis, Rosai-Dorfman DiseaseMAP2K2 (mitogen-activated protein kinase 2) (e.g., cardiofaciocutaneous syndrome), full gene sequence81406Erdheim-Chester Disease, Langerhans Cell Histiocytosis, Rosai-Dorfman DiseaseMUTYH (mutY homolog [E. coli]) (e.g., MYH-associated polyposis), full gene sequence81406Colorectal CarcinomaNF2 (neurofibromin 2 [merlin]) (e.g., neurofibromatosis, type 2), full gene sequence81406Malignant Peritoneal Mesothelioma, Malignant Pleural MesotheliomaPTPN11 (protein tyrosine phosphatase, non-receptor type 11) (e.g., Noonan syndrome, LEOPARD syndrome), full gene sequence81406Chronic Myeloid Leukemia, Myelodysplastic Syndromes,Juvenile Myelomonocytic LeukemiaRAF1 (v-raf-1 murine leukemia viral oncogene homolog 1) (e.g., LEOPARD syndrome), full gene sequence81406Erdheim-Chester Disease, Langerhans Cell Histiocytosis, Rosai-Dorfman DiseaseRET (ret proto-oncogene) (e.g., Hirschsprung disease), full gene sequence81406
Draft Article - Billing and Coding: Genetic Testing for Oncology (DA59125)
RET (ret proto-oncogene) (e.g., Hirschsprung disease), full gene sequence81406Ampullary Adenocarcinoma, Extrahepatic Cholangiocarcinoma, Intrahepatic Cholangiocarcinoma, Gallbladder Cancer, Erdheim-Chester Disease, Langerhans Cell Histiocytosis, Rosai-Dorfman Disease, Multiple Endocrine Neoplasia, Type 2A and B, Neuroendocrine and Adrenal Tumors - Pheochromocytoma/Paraganglioma, Pancreatic Adenocarcinoma, Medullary Thyroid CancerSDHA (succinate dehydrogenase complex, subunit A, flavoprotein [Fp]) (e.g., Leigh syndrome, mitochondrial complex II deficiency), full gene sequence81406Neuroendocrine and Adrenal Tumors - Pheochromocytoma/Paraganglioma, Hereditary Renal Cell CarcinomaSMAD4 (SMAD family member 4) (e.g., hemorrhagic telangiectasia syndrome, juvenile polyposis), full gene sequence81406Hereditary Cancer Testing Criteria: Juvenile Polyposis SyndromeTSC1 (tuberous sclerosis 1) (e.g., tuberous sclerosis), full gene sequence81406Neuroendocrine Tumors of the Pancreas (Well-Differentiated Grade 1/2), Neuroendocrine and Adrenal Tumors - Well-Differentiated Grade 3 Neuroendocrine Tumors, Uterine Sarcoma, Encapsulated Glioma, Hereditary Renal Cell CarcinomaTSC2 (tuberous sclerosis 2) (e.g., tuberous sclerosis), duplication/deletion analysis81406Neuroendocrine Tumors of the Pancreas (Well-Differentiated Grade 1/2), Neuroendocrine and Adrenal Tumors - Well-Differentiated Grade 3 Neuroendocrine Tumors, Uterine Sarcoma, Encapsulated Glioma, Hereditary Renal Cell CarcinomaNOTCH1 (notch 1) (e.g., aortic valve disease), full gene sequence81407T-Lymphoblastic Leukemia/Lymphoma
Draft Article - Billing and Coding: Genetic Testing for Oncology (DA59125)
NOTCH1 (notch 1) (e.g., aortic valve disease), full gene sequence81407T-Lymphoblastic Leukemia/LymphomaTSC2 (tuberous sclerosis 2) (e.g., tuberous sclerosis), full gene sequence81407Neuroendocrine Tumors of the Pancreas (Well-Differentiated Grade 1/2), Neuroendocrine and Adrenal Tumors - Well-Differentiated Grade 3 Neuroendocrine Tumors, Uterine Sarcoma, Encapsulated Glioma, Hereditary Renal Cell CarcinomaATM (ataxia telangiectasia mutated) (e.g., ataxia telangiectasia), full gene sequence81408Ampullary Adenocarcinoma, Pancreatic Adenocarcinoma, Prostate Cancer, Hereditary Cancer Testing Criteria: Breast Cancer, Ovarian Cancer, and Pancreatic CancerNF1 (neurofibromin 1) (e.g, neurofibromatosis, type 1), full gene sequence81408Gastrointestinal Stromal Tumors (GIST), Myelodysplastic Syndromes, Neuroendocrine Tumors of the Pancreas (Well-Differentiated Grade 1/2), Neuroendocrine and Adrenal Tumors - Pheochromocytoma/Paraganglioma, Neuroendocrine and Adrenal Tumors - Well-Differentiated Grade 3 Neuroendocrine Tumors, Soft Tissue Sarcoma - Embryonal rhabdomyosarcoma, Soft Tissue Sarcoma - Malignant peripheral nerve sheath tumor, Neurofibroma, Chronic Myelomonocytic Leukemia, Juvenile Myelomonocytic Leukemia, Hereditary Cancer Testing Criteria: Breast Cancer and Ovarian CancerUtilization ParametersGenetic testing for hereditary cancer syndromes is considered germline testing, and therefore only permitted once per beneficiarys lifecycle.The following tests are germline tests:
Draft Article - Billing and Coding: Genetic Testing for Oncology (DA59125)
Utilization ParametersGenetic testing for hereditary cancer syndromes is considered germline testing, and therefore only permitted once per beneficiarys lifecycle.The following tests are germline tests:812028121581217812938129681299813088131881322813538143281433814358143681437814380101U0102U0103U0129U0130U0131U0132U0133U0134U0135U0162U0238UDocumentation RequirementsAll documentation must be maintained in the patient's medical record and made available to the contractor upon request.Every page of the record must be legible and include appropriate patient identification information (e.g., complete name, dates of service[s]). The documentation must include the legible signature of the physician or non-physician practitioner responsible for and providing the care to the patient.The submitted medical record must support the use of the selected ICD-10-CM code(s). The submitted CPT/HCPCS code(s) must describe the service performed.The medical record must demonstrate that the treating clinician who is responsible for the management of the patients cancer or substantiated suspicion of cancer is the same person as the ordering clinician.The medical record must include documentation to support an established diagnosis of cancer or a substantiated suspicion of cancer.The medical record must include documentation of how the test results will directly impact the management of the patients specific medical problem.The medical record must clearly document the communication and discussion of pre-test and post-test counseling and the risk associated with genetic testing.The medical record from the ordering clinician must clearly indicate all tests that are to be performed.
Draft Article - Billing and Coding: Genetic Testing for Oncology (DA59123)
CMS National Coverage PolicyInternet-Only Manuals (IOMs):CMS IOM Publication 100-04,Medicare Claims Processing Manual,Chapter 16, Section 10 Background, Section 40.8 Date of Service (DOS) for Clinical Laboratory and Pathology Specimens and Section 120.1 Negotiated Rulemaking ImplementationChapter 18 Preventive and Screening ServicesCMS IOM Publication 100-08,Medicare Program Integrity Manual,Chapter 3 Verifying Potential Errors and Taking Corrective ActionsSocial Security Act (Title XVIII) Standard References:Title XVIII of the Social Security Act, Section 1833(e) states that no payment shall be made to any provider of services or other person under this part unless there has been furnished such information as may be necessary in order to determine the amounts due such provider or other person under this part for the period with respect to which the amounts are being paid or for any prior period.Code of Federal Regulations (CFR) References:CFR, Title 42, Subchapter B, Part 410 Supplementary Medical Insurance (SMI) Benefits, Section 410.32 Diagnostic x-ray tests, diagnostic laboratory tests, and other diagnostic tests: ConditionsCFR, Title 42, Section 414.502 DefinitionsCFR, Title 42, Subpart G, Section 414.507 Payment for clinical diagnostic laboratory tests and Section 414.510 Laboratory date of service for clinical laboratory and pathology specimensCFR, Title 42, Part 493 Laboratory RequirementsCFR, Title 42, Section 493.1253 Standard: Establishment and verification of performance specificationsCFR, Title 42, Section 1395y(b)(1)(F) Limitation on beneficiary liabilityMedicare National Correct Coding Initiative (NCCI) Policy Manual:Chapter 10, Section F Molecular PathologyChapter 10, Section M Medically Unlikely Edits (MUEs)Article TextThis Billing and Coding Article provides billing and coding guidance for Local Coverage Determination (LCD) L39367 Genetic Testing for Oncology. Please refer to the LCD for reasonable and necessary requirements.
Draft Article - Billing and Coding: Genetic Testing for Oncology (DA59123)
Article TextThis Billing and Coding Article provides billing and coding guidance for Local Coverage Determination (LCD) L39367 Genetic Testing for Oncology. Please refer to the LCD for reasonable and necessary requirements.All instructions provided within the American Medical Association (AMA) Current Procedural Terminology (CPT) Codebook with rules and guidelines from the AMAs CPT Editorial Panel and the Medicare NCCI Policy Manual should be followed when utilizing CPT codes for billing. Proper coding involves interpreting code descriptions provided by these sources as well as any associated parentheticals. The instructions below do not represent the full breadth or depth of instructions found in the CPT Codebook and the Medicare NCCI Policy Manual. Providers that bill Medicare are expected to follow all instructions found in these sources.Molecular code descriptions in the CPT Codebook generally have some or all of the following components:Medical condition under investigationGenetic content to be testedTechnology/methodology used for testingSpecimen type evaluatedProviders must ensure that their use of molecular CPT codes represent the highest level of specificity in what testing was performed. The following reviews each of these components with general tips for each:1. Medical ConditionWhen a code designates coverage of a specific medical condition (e.g., CPT code 81432 - Hereditary breast cancer- related disorders), all genes billed under this code must fall under the description of the medical condition. Even if all the genes described by a CPT code are tested in a claim, the CPT code can only be used if the described medical condition matches the documented disease.2. Genetic ContentCommonly, molecular CPT codes have a gene(s) listed within their coding description. Special attention must be paid to what elements of a gene are analyzed since not all codes describe the analysis of an entire gene. A gene could be tested for a single well-known variant (e.g., CPT code 81210 - V600 variants in theBRAFgene) or the gene could be fully sequenced (e.g., CPT code 81406  full sequence of theBRAFgene). In fact, several codes in the Tier 1 molecular section cover the same gene but differ in what element of that gene they cover.
Draft Article - Billing and Coding: Genetic Testing for Oncology (DA59123)
For instance, the CPT codes 81201, 81202, and 81203 all describe tests for the same gene,APC, but cover different elements of the gene such as full gene sequence, known familial variants or duplication/deletion variants.As stated in the Medicare NCCI Policy Manual Chapter 10, these codes in general should not be billed together. An exception could be inuncommonscenariossuch as billing a code for full gene sequence with another code for duplication/deletion variants when the disease variants cannot be identified by performing full gene sequencing. Procedures reported together must be both medically reasonable and necessary (e.g., sequencing of procedures) and ordered by the physician who is treating the beneficiary and using the results in the management of the beneficiary's specific medical problem.Less commonly, molecular CPT codes are defined by only a test methodology, as is seen in codes for FluorescenceIn SituHybridization (FISH) found in the Surgical Pathology section of the CPT Codebook. In brief, FISH is a technique where a probe (a short, single-stranded nucleic acid sequence) targets a specific genetic sequence and is labeled/tagged with a fluorescent dye. If the target is found, the fluorescent dye becomes attached to that target and can be seen under microscopy or other related imaging. In oncology, FISH probes are used to evaluate many different genes for many different cancers; however, many FISH CPT codes do not specify which genes or which cancers are being evaluated. As a result, special attention must be paid to what unit of service (UOS) is found in the code description.A UOS for FISH testing could be defined in numerous ways, including number of slides evaluated, number of single source specimens evaluated, number of FISH probes used, number of FISH procedures performed, or number of cells counted. For Medicare, both the CPT Codebook and the Medicare NCCI Policy Manual specify which of these UOS applies, and billing for more UOS than were actually performed is not permitted.The NCCI manual states that regardless of how many blocks or slides are created from a surgical, cytologic, or hematologic specimen, testing multiple blocks or slides from the same specimen source (e.g., tube of blood) still is considered as 1 UOS per source specimen.For example:
Draft Article - Billing and Coding: Genetic Testing for Oncology (DA59123)
The UOS described for CPT code 88373 is both per specimen and each additional single probe stain procedure. Depending on the testing scenario, the code may or may not be used, and should only be used in relation to additional probes NOT additional specimens.If one single probe procedure is used for a specimen from one source (e.g., right iliac crest bone marrow aspiration), only 1 UOS may be claimed, even if multipleslidesfrom the specimen are tested with the same probe:1 UOS with the parent CPT code 88367,0 UOS should be reported with CPT code 88373 since only one single probe procedure was used, regardless of how many slides are made with the single source specimen.If two different single probe procedures are used to evaluate several slides from one source specimen, only 2 UOS may be claimed:1 UOS with the parent CPT code 88367, AND1 UOS with the additional CPT code 88373If one single probe procedure is used on two source specimens (e.g., one bone marrow aspiration specimen from the right iliac crest and another specimen from the left iliac crest), only 2 UOS may be claimed:2 UOS with the parent CPT code 88367,0 UOS should be reported with CPT code 88373 since only one single probe procedure was used.The same logic for single probe stain procedures is also true of using multiplex probe stain procedures (CPT code 88374); the UOS is based on the overall multiplex probe stainprocedureNOT the number ofprobeswithin the multiplex stain.CPT codes that describe a genomic sequencing panel (GSP) often include instructions that define the number of genes covered, for instance using a range (5-50 genes) or using a minimum number required (e.g., at least 10 genes).For instance:CPT code 81436 covers at least five genes and must include the genes MLH1, MSH2, EPCAM, SMAD4, and STK11.This means any test matching the CPT code description for 81436, regardless of whether the test analyzed five genes or 20 genes, would be billed under the CPT code 81436 code with only 1 UOS.
Draft Article - Billing and Coding: Genetic Testing for Oncology (DA59123)
This means any test matching the CPT code description for 81436, regardless of whether the test analyzed five genes or 20 genes, would be billed under the CPT code 81436 code with only 1 UOS.Additionally, this means that any test without all five mandatory genes (MLH1, MSH2, EPCAM, SMAD4, and STK11) would NOT be billed with this code.When a CPT code for a panel is used in this context,no other CPT codes may be used to describe the panel, regardless of presence or absence of modifiers.3. Technology/MethodologyWhen a CPT code description specifies a particular technology and/or testing methodology, only that technology and/or methodology may be used when billing that code. Therefore, special attention must be paid to the full code description, especially if the type of content tested has technology that typically varies from CPT code to CPT code. For example, CPT codes describing a gene expression profiling (GEP) test often include the specific methodology used for that test, such as RT-PCR (e.g., 81518), microarray (e.g., 81521), and next-generation sequencing (e.g., 81523).