Gene Testing Code Restrictions Removed

April 15, 2022

Effective for dates of service on or after May 1, 2022, the Department of Health Care Services (DHCS) has expanded the use of CPT code 81225 (CYP2C19 [cytochrome P450, family 2, subfamily C, polypeptide 19] [eg, drug metabolism], gene analysis, common variants [eg, *2, *3, *4, *8, *17]). The expanded use removes the diagnosis restrictions to include ICD-10-CM codes I21.01 thru I24.9 and adds the code to the Presumptive Eligibility for Pregnant Women (PE4PW) program.

This article was published as part of the April 2022 Medi-Cal Update.