Summary & Overview
CPT 81265: Short Tandem Repeat (STR) Marker Analysis for Genetic Comparison
CPT code 81265 denotes laboratory testing for Short Tandem Repeat (STR) markers used to compare genetic similarity between a patient and another specimen. STR analysis is central to identity verification, relationship testing, forensic comparison, and certain legal or investigational scenarios. As a technical laboratory service, this code reflects the lab-based analytic component rather than clinical interpretation or counseling.
Key payers included in the coverage discussion are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a national-level overview of the code’s clinical context and service setting, coverage considerations by major payers, and common billing elements. The publication summarizes benchmarks where available, highlights policy and coding guidance relevant to laboratory STR testing, and outlines operational points such as typical site of service and the technical nature of the procedure.
This summary is intended for billing managers, laboratory administrators, and policy analysts who need a concise reference to CPT code 81265 — what it represents, why it matters in clinical and legal testing pathways, and the types of payer policies and documentation topics that commonly accompany STR laboratory services. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 81265 describes a laboratory test that evaluates Short Tandem Repeat (STR) markers to compare genetic similarity between a patient and a specimen from another person. The procedure is a technical laboratory service in which a lab analyst performs the assay and generates STR marker data used for identity, relationship, or specimen comparison purposes.
Service type: Genetic identity/forensic laboratory testing (STR analysis)
Typical site of service: Clinical laboratory or reference laboratory
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient scenario involves a laboratory receiving blood or buccal swab specimens from two or more individuals to determine biological relatedness using Short Tandem Repeat (STR) analysis. Common clinical workflows include family relationship testing (paternity or maternity), forensic kinship confirmation, and confirmation of identity in transplant or legal settings. The ordering clinician (often an obstetrician, pediatrician, family law attorney, or forensic examiner) requests 81265 when comparison of multiple STR marker profiles is required. The laboratory performs DNA extraction, amplification of STR loci, capillary electrophoresis, and interpretation of allele patterns to report matches, exclusions, or probabilities of relatedness. Results are documented in the laboratory information system and communicated to the ordering provider or legal custodian according to chain-of-custody and consent requirements.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the professional interpretation component separate from the technical lab work, if applicable for consultative interpretation. |
TC |