2025 CPT code 81420
(Active) Effective Date: N/A Revision Date: N/A Laboratory - Genomic Sequencing Procedures and Other Molecular Multianalyte Assays Pathology and Laboratory Procedures Feed
Genomic sequence analysis panel for fetal chromosomal aneuploidy using circulating cell-free fetal DNA in maternal blood; includes chromosomes 13, 18, and 21.
Modifiers may be applicable depending on the specific circumstances of the service, such as the place of service or the use of assistants.Consult CPT and payer guidelines for appropriate modifier usage.
Medical necessity for 81420 is established when a pregnant woman presents with risk factors for fetal chromosomal aneuploidy.These factors may include advanced maternal age, abnormal ultrasound findings, or a family history of chromosomal abnormalities.The test is considered a screening tool and does not provide a definitive diagnosis, which may require further testing.
The clinical responsibility lies with the laboratory analyst who performs the steps to isolate the cffDNA, sequence the target genes, and interpret the results.This requires expertise in molecular biology techniques, NGS technologies, and genomic interpretation.
- Pathology and Laboratory Procedures
- Pathology and Laboratory Procedures > Genomic Sequencing Procedures and Other Molecular Multianalyte Assays
In simple words: This lab test analyzes a mother's blood to check the baby's chromosomes 13, 18, and 21 for any problems. It helps find out if the baby has Down syndrome or other chromosomal conditions.
This CPT code encompasses a genomic sequence analysis panel designed to evaluate circulating cell-free fetal DNA (cffDNA) obtained from maternal blood.The analysis specifically targets genes located on chromosomes 13, 18, and 21 to detect fetal chromosomal aneuploidy.The procedure involves isolating cffDNA from maternal blood, sequencing the target genes using next-generation sequencing (NGS) or a comparable technology, and comparing the results to a reference genome to identify sequence variations associated with aneuploidy.The method may employ size-based separation techniques for isolating cffDNA. Results are interpreted by a qualified analyst. Note that this code is not limited to detecting specific conditions but may aid in diagnosis of trisomies 21, 18, and 13, among other chromosomal aneuploidies.
Example 1: A pregnant woman undergoes non-invasive prenatal testing (NIPT) to screen for common chromosomal aneuploidies.This test uses 81420 to analyze cffDNA for trisomy 21, 18, and 13., A woman with a history of miscarriage undergoes NIPT to assess fetal chromosomal status.The 81420 code covers the genomic sequencing panel for chromosomes 13, 18, and 21., A high-risk pregnancy due to advanced maternal age prompts an NIPT using this code to screen for aneuploidies of chromosomes 13, 18, and 21.
** This code is for the genomic sequencing panel itself; separate codes may be used for specimen collection (e.g., 36415 for venipuncture) if performed by a different provider.
- Revenue Code: Z2 (Undefined Codes)
- Payment Status: Active
- Modifier TC rule: No TC modifier applies.
- Specialties:Obstetrics, Gynecology, Medical Genetics
- Place of Service:Laboratory