CPT® Code 81595

Cardiology (heart transplant), mRNA, gene expression profiling by real-time quantitative PCR of 20 genes (11 content and 9 housekeeping), utilizing subfraction of peripheral blood, algorithm reported as a rejection risk score

The CPT® Code 81595 pertains to a specialized diagnostic procedure known as gene expression profiling, specifically within the context of cardiology and heart transplantation. This procedure utilizes a subfraction of peripheral blood to assess the expression levels of 20 specific genes, which include 11 genes associated with transplant rejection and 9 housekeeping genes that serve as controls. The primary aim of this test is to detect acute heart transplant rejection or the onset of graft dysfunction, providing critical information that can guide clinical decision-making. Gene expression profiling involves analyzing how genetic information is translated into functional proteins or mRNA, thereby indicating which genes are actively expressed (producing mRNA or proteins) and which are not (not producing mRNA or proteins) in the blood sample. The testing process employs real-time quantitative polymerase chain reaction (RT-PCR) technology to quantify the expression levels of these genes. The results are then processed through a computer algorithm that evaluates the contribution of each gene to the overall assessment, culminating in a rejection risk score. This score can be instrumental in conjunction with other diagnostic methods, such as endomyocardial biopsy, to tailor immunosuppressant therapy based on the graft's functional status and the degree of acute cellular rejection.