CPT Code Lookup Tool
Use this free CPT Lookup Tool to search for Current Procedural Terminology (CPT) codes, descriptions, and related details — designed to help streamline and simplify your medical billing process.
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Office or other outpatient visit
Evaluation and management of an established patient...
Information
This code is for use in medical billing and coding.
Information
This code is part of the section of CPT codes.
Office or other outpatient visit for the evaluation and management...
Note
This description reflects the 2021 E/M coding guidelines.
Information
codes are used to report evaluation and management services provided in various settings.
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RVUs are used to determine the fee for a service under the Medicare Physician Fee Schedule.
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This code is commonly used by primary care providers, but may be used by any specialty providing office visits.
Significant, separately identifiable E/M service
Information
Modifiers provide additional information about the service provided.
Detail About CPT 81513
Related Codes Table
| CPT Code | Description |
|---|---|
| 81512 | Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 16 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence score |
| 81514 | Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 50 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence score |
| 81515 | Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 70 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence score |
| 81516 | Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 21 genes, utilizing fresh tissue, algorithm reported as recurrence score |
| 81517 | Oncology (breast), mRNA, gene expression profiling by real-time RT-PCR of 50 genes, utilizing fresh tissue, algorithm reported as recurrence score |
Commonly Billed With
CPT code 81513 is commonly billed with additional molecular pathology procedures for comprehensive breast cancer evaluation.
Clinical Scenarios
Breast Cancer Diagnosis Confirmation:
Use CPT code 81513 to confirm the diagnosis of breast cancer through gene expression profiling.
Treatment Decision Support:
Physicians may use the results from CPT code 81513 to guide treatment decisions for patients with breast cancer.
Recurrence Risk Assessment:
This test helps assess the risk of cancer recurrence in patients with breast cancer.
Treatment Response Monitoring:
CPT code 81513 can also be used to monitor the response to treatment in breast cancer patients.
FAQ
What is the purpose of CPT code 81513?
CPT code 81513 is used for gene expression profiling in breast cancer to assess recurrence risk.
Is CPT code 81513 specific to breast cancer?
Yes, this code is specifically for oncology (breast) and gene expression profiling using RT-PCR.
Can CPT code 81513 be used for other types of cancer?
No, this code is intended for breast cancer gene expression profiling only.
How does CPT code 81513 contribute to treatment decisions?
The results from this test help physicians make informed decisions about treatment options for breast cancer patients.
Is prior authorization required for CPT code 81513?
Prior authorization may be necessary depending on the insurance provider and specific clinical scenario.
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