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2025 CPT code 88272

Molecular cytogenetics: chromosomal in situ hybridization, analyzing 3-5 cells (e.g., for derivatives and markers).

Adhere to the CPT coding guidelines for pathology and laboratory services, including those specifically related to cytogenetic studies.Appropriate use of modifiers is essential to ensure accurate reimbursement.

Modifiers may be applicable depending on the circumstances of service.Refer to the CPT manual for specific modifier usage guidelines.

Medical necessity for 88272 is established based on clinical suspicion of a chromosomal disorder or genetic condition, guided by the patient's symptoms, medical history, and other relevant clinical findings.The test is typically medically necessary for prenatal diagnosis, cancer diagnosis and management, or the investigation of developmental disorders.

A cytogenetics laboratory specialist performs the technical aspects of the test. A board-certified cytogeneticist reviews the results and provides the interpretation, considering patient history and other clinical findings.

IMPORTANT:For analysis of 10-30 cells, see CPT code 88273.For procedures not listed in CPT codes 88230-88291 and not in the Surgical Pathology (88300-88388) subsection, use unlisted cytogenetic study code 88299. Molecular pathology procedures should utilize codes from Tier 1 (81161, 81200-81383), Tier 2 (81400-81408), Genomic Sequencing Procedures and Other Molecular Multianalyte Assays (81410-81471), or Multianalyte Assays with Algorithmic Analyses (81500-81512) sections, or unlisted codes 81479 or 81599 if no specific code applies. Specific alternative codes are provided for acetylcholinesterase (82013), alpha-fetoprotein (82105, 82106), and laser microdissection (88380).

In simple words: This lab test uses special techniques to look at a few cells from a blood or fluid sample to check for problems with the chromosomes. It helps detect changes in the chromosomes that can cause genetic conditions.

This CPT code encompasses the performance of a molecular cytogenetic test utilizing chromosomal in situ hybridization (CISH) techniques to analyze a small number of cells (3-5) for chromosomal abnormalities.The cells are typically obtained from amniotic fluid or blood samples.Methods such as fluorescence in situ hybridization (FISH) are commonly employed to detect genetic anomalies like derivatives (rearranged chromosomes) and markers (unidentifiable chromosomes). The procedure involves preparing cells on a slide, exposing the DNA, applying fluorescently tagged molecular probes specific to target DNA sequences, hybridizing the probes, washing off excess material, and finally analyzing the sample under a fluorescence microscope to identify the presence, absence, or position of the specific DNA sequence. The results reveal the presence of chromosomal abnormalities.

Example 1: A pregnant woman undergoes amniocentesis, and the obtained amniotic fluid is tested using 88272 to screen for chromosomal abnormalities in the fetus, such as trisomy 21 (Down syndrome)., A patient presents with suspected leukemia, and a bone marrow sample is analyzed using 88272 to detect specific chromosomal translocations, like the Philadelphia chromosome, indicative of chronic myeloid leukemia., A child with developmental delays undergoes genetic testing, and 88272 is used to investigate the presence of microdeletions or other chromosomal rearrangements associated with specific syndromes.

* Physician’s order specifying the test.* Patient demographics and relevant medical history.* Specimen type (e.g., amniotic fluid, blood) and collection date.* Results of the chromosomal in situ hybridization analysis.* Report from the board-certified cytogeneticist interpreting the findings.

** Always verify code accuracy with the most current CPT codebook and payer-specific guidelines before billing.

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