Summary & Overview
CPT 81422: Genomic Sequence Analysis for Fetal Chromosomal Microdeletions
CPT code 81422 represents a genomic sequence analysis panel designed to detect chromosomal microdeletions in circulating cell–free fetal DNA from maternal blood. This advanced molecular assay is crucial for early identification of conditions such as DiGeorge syndrome and Cri–du–chat syndrome, offering significant clinical value in prenatal care. The code is widely recognized across major national payers, including Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare, reflecting its importance in coverage and reimbursement policies.
This publication provides a comprehensive overview of 81422, detailing its clinical applications, payer coverage landscape, and relevant benchmarks. Readers will gain insight into current policy updates, utilization trends, and the broader context of genomic sequencing in prenatal screening. The analysis also highlights associated service types, typical laboratory settings, and related procedural codes, equipping stakeholders with essential information for understanding the role of this test in modern maternal-fetal medicine.
CPT Code Overview
CPT code 81422 is used for genomic sequence analysis panels that evaluate circulating cell–free fetal DNA in maternal blood for chromosomal microdeletion(s). This testing is associated with conditions such as DiGeorge syndrome and Cri–du–chat syndrome. The procedure falls under the category of Pathology and Laboratory Procedures, specifically Genomic Sequencing Procedures and Other Molecular Multianalyte Assays. The typical site of service for this test is a laboratory, designated as Place of Service 81.
Clinical & Coding Specifications
Clinical Context
A pregnant patient presents for non-invasive prenatal testing during the first trimester. The clinical workflow involves collecting a maternal blood sample to evaluate circulating cell–free fetal DNA for chromosomal microdeletion syndromes, such as DiGeorge or Cri–du–chat. The test is performed in a laboratory setting (POS 81) and is typically ordered by an obstetrics & gynecology physician, genetic counselor, or medical geneticist. The results assist in antenatal screening and maternal care planning for suspected chromosomal abnormalities in the fetus.
Coding Specifications
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Modifiers:
26: Professional Component – Used when only the interpretation of the test is performed by the provider.TC: Technical Component – Used when only the technical aspect (e.g., sample processing, analysis) is performed.
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Provider Taxonomies:
Code Specialty 207SG0201X