American Association for Clinical Chemistry 2018 Clinical Laboratory Fee Schedule Recommendations August 11, 2017

New Code 2018 CPT Description AACC AACC Rationale 2017 NLA Crosswalk Molecular Pathology 81X31 CYP3A5 (cytochrome 81225 The resources required and the $293.40 P450 family 3 subfamily amount of DNA queried is A member 5) (eg, drug comparable to 81225. AACC metabolism) recommends a crosswalk to analysis, common 81225. variants (eg, *2, *3, *4, *5 *6, *7) 81X32 DPYD 81227 The resources utilized by DPYD $176.03 (dihydropyrimidine and CYPC29 are similar. AACC dehydrogenase) (eg, 5- recommends a crosswalk to fluorouracil/5-FU and 81227. capecitabine drug metabolism) gene analysis, common variant(s) (eg, *2A, *4, *5, *6)

81X25 F9 ( factor 81321 Similar amounts of DNA are $604.00 IX) (eg, hemophilia B) interrogated in PTEN and F9 full full gene sequence gene analyses due to the similarity of the number of exons performed. AACC suggests a crosswalk to 81321 since similar resources are utilized. 81X38 G6PD (glucose-6- 81215 Since both codes represent $93.75 phosphate sequencing of one variant in one dehydrogenase) (eg, exon, AACC recommends a hemolytic anemia, crosswalk to 81215 as the most jaundice) gene analysis; appropriate way to capture the known familial resources required to perform variant(s) the G6PD known familial variants. 81X40 G6PD (glucose-6- 81321 Given the methods for $604.00 phosphate sequencing and the amount of dehydrogenase) (eg, DNA sequenced is comparable hemolytic anemia, for PTEN and G6PD full analyses, jaundice) gene analysis; we suggest a crosswalk to 81321, full gene sequence where similar resources are utilized. 81X15 Human Antigen 81376 AACC recommends a crosswalk $167.66 1 genotyping (HPA-1), to 81376 due to similar resources ITGB3 (, beta 3 and work performed. 81376 [platelet glycoprotein represents HLA one assay, IIIa], antigen CD61 that is essentially one SNP, which [GPIIIa]) (eg, neonatal makes it a reasonable crosswalk alloimmune for the Human Platelet Antigen thrombocytopenia genotyping. [NAIT], post-transfusion purpura) gene analysis, common variant, HPA- 1a/b (L33P) 81X16 Human Platelet Antigen 81376 AACC recommends a crosswalk $167.66 2 genotyping (HPA-2), to 81376 due to similar resources GP1BA ( and work performed. 81376 [platelet], alpha represents HLA one locus assay, polypeptide [GPIba]) that is essentially one SNP, which (eg, neonatal makes it a reasonable crosswalk alloimmune for the Human Platelet Antigen thrombocytopenia genotyping. [NAIT], post-transfusion purpura) gene analysis, common variant, HPA- 2a/b (T145M) 81X17 Human Platelet Antigen 81376 AACC recommends a crosswalk $167.66 3 genotyping (HPA-3), to 81376 due to similar resources ITGA2B (integrin, alpha and work performed. 81376 2b [platelet represents HLA one locus assay, glycoprotein IIb of that is essentially one SNP, which IIb/IIIa complex], makes it a reasonable crosswalk antigen CD41 [GPIIb]) for the Human Platelet Antigen (eg, neonatal genotyping. alloimmune thrombocytopenia [NAIT], post-transfusion purpura) gene analysis, common variant, HPA- 3a/b (I843S) 81X18 Human Platelet Antigen 81376 AACC recommends a crosswalk $167.66 4 genotyping (HPA-4), to 81376 due to similar resources ITGB3 (integrin, beta 3 and work performed. 81376 [platelet glycoprotein represents HLA one locus assay, IIIa], antigen CD61 that is essentially one SNP, which [GPIIIa]) (eg, neonatal makes it a reasonable crosswalk alloimmune for the Human Platelet Antigen thrombocytopenia genotyping. [NAIT], post-transfusion purpura) gene analysis, common variant, HPA- 4a/b (R143Q 81X19 Human Platelet Antigen 81376 AACC recommends a crosswalk $167.66 5 genotyping (HPA-5), to 81376 due to similar resources ITGA2 (integrin, alpha 2 and work performed. 81376 [CD49B, alpha 2 subunit represents HLA one locus assay, of VLA-2 receptor] that is essentially one SNP, which [GPIa]) (eg, neonatal makes it a reasonable crosswalk alloimmune for the Human Platelet Antigen thrombocytopenia genotyping. [NAIT], post-transfusion purpura) gene analysis, common variant (eg, HPA-5a/b (K505E)) 81X20 Human Platelet Antigen 81376 AACC recommends a crosswalk $167.66 6 genotyping (HPA-6w), to 81376 due to similar resources ITGB3 (integrin, beta 3 and work performed. 81376 [platelet glycoprotein represents HLA one locus assay, IIIa, antigen CD61] that is essentially one SNP, which [GPIIIa]) (eg, neonatal makes it a reasonable crosswalk alloimmune for the Human Platelet Antigen thrombocytopenia genotyping. [NAIT], post-transfusion purpura) gene analysis, common variant, HPA- 6a/b (R489Q) 81X21 Human Platelet Antigen 81376 AACC recommends a crosswalk $167.66 9 genotyping (HPA-9w), to 81376 due to similar resources ITGA2B (integrin, alpha and work performed. 81376 2b [platelet represents HLA one locus assay, glycoprotein IIb of that is essentially one SNP, which IIb/IIIa complex, antigen makes it a reasonable crosswalk CD41] [GPIIb]) (eg, for the Human Platelet Antigen neonatal alloimmune genotyping. thrombocytopenia [NAIT], post-transfusion purpura) gene analysis, common variant, HPA- 9a/b (V837M) 81X22 Human Platelet Antigen 81376 AACC recommends a crosswalk $167.66 15 genotyping (HPA- to 81376 due to similar resources 15), CD109 (CD109 and work performed. 81376 molecule) (eg, neonatal represents HLA one locus assay, alloimmune that is essentially one SNP, which thrombocytopenia makes it a reasonable crosswalk [NAIT], post-transfusion for the Human Platelet Antigen purpura) gene analysis, genotyping. common variant, HPA- 15a/b (S682Y) 81X23 IDH1 (isocitrate 81275 The resources involved in $198.57 dehydrogenase 1 performing IDH1 and KRAS tests [NADP+], soluble) (eg, are equivalent. AACC glioma), common recommends a crosswalk to variants (eg, R132H, 81275 due to the similarities in R132C) materials and resources. 81X24 IDH2 (isocitrate 81311 The materials and resources $297.86 dehydrogenase 2 involved in performing IDH2 and [NADP+], NRAS are similar. AACC mitochondrial) (eg, recommends a crosswalk to glioma), common 81311. variants (eg, R140W, R172M) 81X33 IFNL3 (interferon, 81241 The current description of this $83.82 lambda 3) (eg, drug gene is "IL28B (interleukin 28B response) gene analysis, [interferone, lambda 3] (eg, drug rs12979860 variant response), rs 12979860 variant)" listed in the Tier 2 gene test list as 81400. AACC suggests a crosswalk from CPT 81241, Leiden, as similar work and resources are performed for both F5 and IFNL3.

81X36 TYMS (thymidylate 81245 Similar resources are used in $166.84 synthetase) (eg, 5- TPMT and FLT3. AACC fluorouracil/5-FU drug recommends a crosswalk to metabolism) gene 81245. analysis, common variant(s) (eg, tandem repeat variant) 813X3 HBB (hemoglobin, 81294 Methods are comparable for $191.72 subunit beta) (eg, sickle del/dups of MLH1 and HBB. cell anemia, beta AACC recommends a crosswalk thalassemia, to 81294 due to the use of similar hemoglobinopathy); resources. duplication/deletion variant(s) 813X4 HBB (hemoglobin, 81235 The amount of DNA sequence is $331.82 subunit beta) (eg, sickle comparable to EGFR common cell anemia, beta variant testing. AACC thalassemia, recommends a crosswalk to hemoglobinopathy); full 81235 due to the utilization of gene sequence similar resources. Reconsidered Codes 81327 SEPT9 (Septin9) (eg, 81288 The revised AMA description $160.76 colorectal cancer) closely reflects the existing 81288 methylation analysis code for MLH1. AACC recommends a crosswalk to 81288 due to similar work and resources.