Advancing The Profession of Pharmacy

Pharmacogenomic (PGx) Testing for Consultant Pharmacists

by | Oct 17, 2018 | Consulting Pharmacist Education

Want to watch a video version of this post?  I’ve got you covered!

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:

  1. In collaboration with the practice, to create a formulary of drugs that would benefit from a pharmacogenomic test
  2. Use pharmacogenomic testing in practices to offer annual wellness visits (AWVs) or chronic care management (CCM) services. A consultant pharmacist could have an ongoing impact on a patients care and continue to use the test throughout the life of the patient.
  3. If you’re seeing patients and giving them the results of their pharmacogenomics test in a physician’s office setting under collaborative practice you can bill for the pharmacists interpretation using the incident to billing codes.


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!

If you are interested in building your clinical services…

Join us on our next LIVE webinar, Sunday, November 18th at 8pmCDT

Learn how to Protect Yourself From Career Climate Change with Consulting as a Side Business

and how the Pharmapreneur Academy can help you build the Career of Your Dreams!

Register HERE.

 

About the Author

Blair Thielemier, PharmD, is an MTM consultant pharmacist specializing in pharmacy billing models. She consults on and produces e-learning programs for state and national organizations, pharmacy wholesalers, payers, technology start-ups. She has books and online courses available for individuals looking to leverage their pharmacy knowledge into monetized clinical programs at PharmapreneurAcademy.com. She speaks internationally about trends in leveraging pharmacists to improve value-based care.

 

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