CPT® Code 81500

Oncology (ovarian), biochemical assays of two proteins (CA-125 and HE4), utilizing serum, with menopausal status, algorithm reported as a risk score

The CPT® Code 81500 pertains to a specific set of biochemical assays utilized in the field of oncology, particularly for evaluating the risk of ovarian cancer in women presenting with pelvic or ovarian masses. This procedure involves the measurement of two critical protein markers: Cancer Antigen 125 (CA-125) and Human Epididymis Protein 4 (HE4). The test is designed to assess the likelihood of malignancy based on these biomarkers, which are analyzed in conjunction with the patient's menopausal status and age. The results are reported as a risk score through a method known as the Risk of Ovarian Malignancy Algorithm (ROMA). The testing process begins with the collection of a blood sample, which is obtained through a procedure known as venipuncture. The serum extracted from this sample undergoes two distinct assays: CA-125 is measured using a quantitative electrochemiluminescent immunoassay, while HE4 is assessed through a quantitative enzyme immunoassay. The combination of these tests provides valuable diagnostic information that aids healthcare professionals in determining the risk of ovarian cancer, thereby guiding further clinical decision-making. This procedure is particularly significant for women who exhibit symptoms or findings suggestive of ovarian pathology, as it helps in stratifying their risk and planning appropriate management strategies.