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What is Pharmacogenomic (PGx) Testing?
Pharmacogenomic testing is identifying genes that may affect enzymes responsible for hepatic metabolism of certain medications.
Remember back in pharmacology and genetics you may remember learning about the Cytochrome P450 enzymes.
Those enzymes are some of the ones that we look at in a pharmacogenomic test.
What Genes Are Tested?
In addition to the CYP450 enzymes, we also look at HLA-A and HLA-B, which indicate the presence of alleles linked to hypersensitivity to carbamazepine or phenytoin.
We also look at OPRM1 which in our mind geotag specifically shows a decreased sensitivity to analgesic but it could go either way.
We also look at the COMT which indicates whether or not the body is producing enzymes that can clear dopamine norepinephrine from the synapse.
We also look at SLCO1B1 which tells us if the patient is more at risk for statin-induced myopathy.
And finally for thrombosis risk we can look at genes that code for Factors 2, 5, and 10 Leiden.
How Do You Bill for Pharmacogenomic Testing?
As far as CPT codes go, there are no CPT codes that code specifically for pharmacogenomic testing.
The patient can be referred to the pharmacist or to the physician for pharmacogenomic testing based on the medications that they're on and based on their diagnosis.
Some impactful activities for pharmacists wanting to offer pharmacogenomic testing either in their community pharmacy setting or in a physician's office setting are:
To refer back to the incident to billing criteria, check out our last video on incident-to billing.
How can you put a program like this together?
A consultant pharmacist in an off site setting such as a community pharmacy or independent consulting firm could integrate pharmacogenomic testing and consultation into an MTM visit
Lesson 9 in the E-course at the Pharmapreneur Academy is ALL about Pharmacogenomic and Point of Care Testing Services!
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ABOUT THE AUTHOR:
Blair Green Thielemier, PharmD is an independent consultant pharmacist living in Arkansas with her husband and two children. Her latest project is the host and producer of pharmacy’s first virtual conference, the Elevate Pharmacy Virtual Summit in partnership with the NCPA Innovation Center. She is the founder of Pharmapreneur Academy, an online e-Course and Community where she guides pharmacist-entrepreneurs through the process and barriers of building a pharmacy consulting business. She is the author of How to Build a Pharmacy Consulting Business and facilitates in-person Business Planning Workshops and Mastermind Retreats for female Pharmapreneurs across the country. More information about Dr. Thielemier can be found on her website.