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2025 CPT code 88271

Molecular cytogenetic analysis using a DNA probe (e.g., FISH), per probe.

Refer to the AMA CPT® manual for detailed guidelines on reporting this code.Specific guidelines for interpreting results vary among specialties.

Modifiers may be applicable in certain situations (e.g., modifier 59 for distinct procedural service, modifier 90 for reference lab).Refer to the CPT® manual and payer-specific guidelines.

Medical necessity for FISH testing is established when the results will directly influence patient management decisions.This may include diagnosis, prognosis, or treatment selection.Specific indications vary depending on the clinical scenario but generally revolve around evaluating chromosomal abnormalities suggestive of genetic disorders, hematologic malignancies, or solid tumors.

The clinical responsibility lies with the ordering physician who interprets the results in the context of the patient's clinical presentation and other diagnostic findings. The laboratory analyst performs the technical aspects of the FISH test, including sample preparation, probe application, hybridization, and microscopic analysis.

IMPORTANT:For cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities, see codes 81228, 81229, 81349, 81405, 81406, 81479.For genomic sequencing procedures or other molecular multianalyte assays for copy number analysis using circulating cell-free fetal DNA in maternal blood, see codes 81420, 81422, 81479.Codes 88272-88291 are related cytogenetic study codes.For in situ hybridization as an adjunct to surgical pathology or cytopathology, use codes 88365-88377.

In simple words: This lab test checks for genetic problems in cells using a special technique called FISH.A tiny labeled piece of DNA is added to the sample to find specific genes. The test shows if the genes are present, missing, or in the wrong place. The lab bills for each separate part of the DNA they test.

This CPT code reports the performance of a molecular cytogenetic test using a DNA probe method, such as fluorescence in situ hybridization (FISH).The procedure involves applying a fluorescently labeled DNA probe to a specimen (e.g., bone marrow, lymph nodes, blood, tumor, amniotic fluid) to detect specific DNA sequences. The probe hybridizes with complementary DNA sequences on chromosomes, and fluorescence microscopy is used to visualize the results, revealing the presence, absence, or location of the target sequence. Each probe tested is reported separately using this code.The analysis may be used to identify chromosomal abnormalities related to inherited disorders or acquired cancers.

Example 1: A patient presents with suspected Down syndrome.Amniotic fluid is collected and sent to the laboratory for FISH analysis targeting chromosome 21 to confirm trisomy 21., A patient with a history of breast cancer undergoes bone marrow biopsy. FISH testing is performed on the bone marrow sample to assess for minimal residual disease (MRD) by targeting specific chromosomal rearrangements associated with the cancer., A patient presents with leukemia.Peripheral blood is collected for FISH analysis to identify specific chromosomal translocations associated with various types of leukemia. Multiple probes are used simultaneously, requiring separate reporting of each using 88271.

* Patient demographics and relevant medical history* Physician's order specifying the target DNA sequences for analysis* Specimen type and source (e.g., blood, bone marrow, amniotic fluid, tissue)* Date and time of specimen collection* Complete results report from the laboratory, including images if available* Clinician’s interpretation of results within the context of patient’s medical condition.

** This code is specific to the testing of each individual DNA probe.If multiple probes are used, each must be reported separately. Proper documentation is crucial for accurate coding and reimbursement. The use of this code might be impacted by the availability of more comprehensive molecular tests for specific genetic abnormalities.

** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.

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