MedicaidBilling CodesMedium impact
Correction to “Pharmacogenetics” in the Medical and Nursing Specialists, Physicians, and Physician Assistants Handbook
Texas Medicaid·TX · Internal Medicine, Family Medicine, Cardiology +2 more·General
We identified it
Mar 14, 2026
Summary
TMHP corrected errors in the Texas Medicaid handbook for pharmacogenetics testing: the correct gene code is 2C19 (not 2C9) and the correct procedure code is 81225 (not 81227). These corrections will be officially updated in the April TMPPM release.
Action Required
By April 2024 TMPPM release: Billing team must verify system uses correct CPT code 81225 for pharmacogenetics testing of polymorphic 2C19. Remove any references to incorrect code 81227. Update encounter forms and billing templates to reflect 2C19 gene testing (not 2C9). Contact TMHP at 800-925-9126 if questions arise about pharmacogenetics billing.