2025 CPT code 88299
(Active) Effective Date: N/A Pathology and Laboratory Procedures - Cytogenetic Studies Pathology and Laboratory Feed
Unlisted cytogenetic study.
Modifiers may be applicable to 88299. For instance, modifier 59 is often required to indicate a distinct procedural service.
Medical necessity for 88299 must be clearly established through documentation that demonstrates why a listed procedure code was not appropriate and explains the clinical rationale for the performed study. This should be linked to the patient's diagnosis, signs, and symptoms.
The clinical responsibility for this code falls on the laboratory professional performing the cytogenetic analysis. They must ensure the proper performance, interpretation, and reporting of the study results.
In simple words: This code is used when a lab performs a chromosome study that doesn't have its own specific code.
This code is used for cytogenetic study procedures that are not otherwise specified in the CPT codebook, specifically those not found in codes 88230-88291 and 88300-88388.It covers analyses not fitting standard karyotyping, fluorescence in situ hybridization (FISH), or other listed cytogenetic tests.
Example 1: A patient presents with ambiguous genitalia.Standard karyotyping and FISH analysis are inconclusive. A more complex chromosomal microarray analysis is performed to identify potential microdeletions or microduplications related to the patient's condition.This complex analysis, not otherwise listed, would be billed using 88299., A child with developmental delays and dysmorphic features undergoes cytogenetic testing. Standard tests are negative.A specialized comparative genomic hybridization (CGH) study is performed to detect copy number variations not identifiable through routine cytogenetics. This specialized CGH analysis would be coded using 88299., A cancer patient requires a complex cytogenetic analysis beyond standard karyotyping and FISH to assess chromosome instability and guide treatment decisions. A specialized spectral karyotyping (SKY) study is performed, which is not covered by a specific CPT code. 88299 is used to report this specialized analysis.
Documentation should include a detailed report of the procedure performed, the interpretation of the results, and the clinical indication for the study.Since this is an unlisted code, thorough documentation comparing the study to the closest listed procedures is crucial for justifying medical necessity and proper reimbursement.
** Always check for newly released CPT codes to ensure 88299 is still the appropriate code before billing. Consulting with a coding expert or using coding software with the latest updates is recommended.
- Specialties:Clinical Genetics, Pathology, Oncology, Pediatrics
- Place of Service:Independent Laboratory, Hospital Outpatient, Office