2025 CPT code 88275
(Active) Effective Date: N/A Revision Date: N/A Laboratory - Cytogenetic Studies Pathology and Laboratory Procedures Feed
Molecular cytogenetics; interphase in situ hybridization, analysis of 100-300 cells.
Modifiers may be applicable depending on the circumstances of service.Consult the CPT manual and payer-specific guidelines for appropriate modifier usage.
Medical necessity for code 88275 is established based on the patient's clinical presentation, risk factors, and the need to detect specific chromosomal abnormalities to aid in diagnosis, prognosis, treatment planning, and management of various medical conditions. The ordering physician must document the medical reason for ordering this test.
The clinical responsibility lies with the ordering physician, who interprets the results in the context of the patient's clinical presentation and other diagnostic information.The cytogenetics laboratory performs the technical aspects of the test.
In simple words: This lab test checks for chromosome problems in a sample of your cells (like blood or tissue). It uses special markers to light up specific parts of chromosomes under a microscope, helping doctors find things like extra or missing pieces of chromosomes that can cause diseases.
This CPT code encompasses the performance of a molecular cytogenetic test using interphase in situ hybridization (ISH) and analysis of 100 to 300 cells.Interphase refers to the period when a cell is not dividing, and chromosomes are tightly packed. The procedure involves applying fluorescently labeled DNA probes to a specimen (e.g., bone marrow, lymph nodes, blood, tumor tissue, amniotic fluid) to detect specific DNA sequences.Analysis is performed via fluorescence microscopy, examining the presence, absence, or location of fluorescent signals indicating chromosomal abnormalities.The method is suitable for various specimen types, including formalin-fixed or paraffin-embedded tissues. The test is used to detect chromosomal abnormalities associated with inherited disorders or cancers.
Example 1: A pregnant woman undergoes amniocentesis, and the amniotic fluid is sent for interphase FISH analysis using code 88275 to screen for chromosomal abnormalities such as trisomy 21 (Down syndrome)., A patient with suspected leukemia has bone marrow aspirated, and the sample undergoes interphase FISH testing (88275) to detect specific chromosomal translocations associated with the disease., A patient with breast cancer undergoes tumor biopsy, and the tissue is sent for interphase FISH analysis (88275) to assess HER2 gene amplification, which has implications for targeted therapy selection.
* Physician's order specifying the test and the reason for ordering.* Patient demographics and relevant clinical history.* Specimen collection and handling information.* Results of the interphase FISH analysis, including the number of cells analyzed and the interpretation.
** This code is for analysis of 100-300 cells. Different codes are available for different numbers of cells analyzed. The specific probes used should be documented appropriately, and the report should include the number of cells analyzed, the interpretation, and any additional relevant findings.
- Revenue Code: T1H (LAB TESTS - OTHER (NON-MEDICARE FEE SCHEDULE))
- RVU: Information not provided. RVUs vary by payer and geographic location. Consult payer-specific fee schedules for current reimbursement rates.
- Global Days: Not applicable. This is a laboratory test, not a surgical procedure.
- Payment Status: Active
- Modifier TC rule: Not applicable. This is a laboratory test, and the Technical Component (TC) modifier does not apply.
- Fee Schedule: Historical fee schedule data is not available in the provided source.Consult historical CPT fee schedules and payer-specific data for reimbursement information.
- Specialties:Medical Genetics, Hematology/Oncology, Pathology, Obstetrics/Gynecology
- Place of Service:Office, Hospital, Laboratory, Ambulatory Surgical Center