Summary & Overview
CPT 81421: Fetal Chromosomal Aneuploidy Genomic Sequence Analysis Panel
CPT code 81421 represents a genomic sequence analysis panel for detecting fetal chromosomal aneuploidy, including conditions such as trisomy 21 and monosomy X, using cell-free fetal DNA from maternal blood. This test is a cornerstone of modern prenatal screening, offering non-invasive, highly accurate detection of chromosomal abnormalities. The code requires analysis of chromosomes 13, 18, and 21, which are associated with the most common and clinically significant fetal aneuploidies.
Blue Cross Blue Shield is the primary payer covered in this analysis. Readers will gain insight into the clinical context of 81421, including its role in prenatal care, typical laboratory site of service, and its relationship to other genetic testing codes. The publication also covers relevant policy updates, coding benchmarks, and the importance of this test in national prenatal screening practices. The summary provides a comprehensive overview for healthcare professionals, laboratory administrators, and policy stakeholders seeking to understand the utilization and coverage landscape for fetal chromosomal aneuploidy testing.
CPT Code Overview
CPT code 81421 is used for genomic sequence analysis panels that detect fetal chromosomal aneuploidy, such as trisomy 21 and monosomy X, through circulating cell-free fetal DNA in maternal blood. This test must include analysis of chromosomes 13, 18, and 21. The service type is genetic testing, and it is typically performed in a laboratory setting (Place of Service 81). This code is central to prenatal screening protocols, providing critical information for early detection of chromosomal abnormalities during pregnancy.
Clinical & Coding Specifications
Clinical Context
A pregnant patient presents for routine prenatal care and is offered non-invasive prenatal testing (NIPT) to screen for common fetal chromosomal aneuploidies, such as trisomy 21 (Down syndrome), trisomy 18, and trisomy 13. The test involves collecting a blood sample from the mother, which is sent to a laboratory for genomic sequence analysis of circulating cell-free fetal DNA. The ordering provider may be an obstetrician, genetic counselor, or medical geneticist. The laboratory performs the analysis and reports results to the provider, who discusses findings with the patient as part of antenatal screening and pregnancy supervision, especially in cases of high-risk pregnancies or suspected chromosomal abnormalities.
Coding Specifications
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Modifiers:
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26: Used to indicate the professional component of the service, typically when the interpretation of the test is performed by a physician or qualified healthcare professional. - Modifier
TC: Used to indicate the technical component, which covers the laboratory processing and analysis of the specimen.
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Provider Taxonomies:
Taxonomy Code Specialty Name