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CPT 81422: Fetal Microdeletion Panel via Cell‑Free Fetal DNA
CPT code 81422 represents a genomic sequence analysis panel that evaluates circulating cell–free fetal DNA in maternal blood to detect chromosomal microdeletions associated with syndromes such as DiGeorge and Cri‑du‑chat. This noninvasive prenatal screening test provides insight into specific subchromosomal deletions that may affect fetal development and can inform further diagnostic evaluation. Nationally, such testing influences prenatal care pathways, genetic counseling demand, and downstream diagnostic services.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for use of this panel, typical sites of service, and how this service fits alongside related sequencing panels for fetal aneuploidy. The publication summarizes coverage themes and payer approach variations, common billing considerations, and connections to relevant diagnostic indications used in prenatal screening.
The report is structured to provide quick-reference benchmarks and policy summaries, highlight clinical scenarios where the panel is ordered, and map adjacent procedure codes for laboratory genomic testing. This material is intended for billing managers, laboratory directors, and clinical administrators seeking concise policy and coding context for noninvasive prenatal microdeletion sequencing panels.
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Billing Code Overview
CPT code 81422 describes a genomic sequence analysis panel performed on maternal blood to evaluate circulating cell–free fetal DNA for chromosomal microdeletions, such as those associated with DiGeorge syndrome or Cri–du–chat syndrome. The service involves laboratory analysis of fetal cell‑free DNA obtained from a maternal blood sample to detect small chromosomal deletions that may indicate specific genetic syndromes.
Service type: Noninvasive prenatal genetic screening using cell‑free fetal DNA sequencing panels
Typical site of service: Clinical laboratory or hospital-based laboratory
National Reimbursement Benchmarks
For CPT 81422 the average commercial benchmark is represented by BUCA at $724.70, with a median of $652.80 and interquartile spread from $472.90 to $879.10. Blue Cross Blue Shield (BCBS) shows the highest dispersion among listed payers: its P75 minus P25 equals $926.60 ($948.80 - $602.20), indicating wide variability in commercial contract rates. Cigna has the next-largest IQR at $660.90 ($1,035.90 - $387.50), while Aetna’s IQR is comparatively narrow at $389.00 ($633.00 - $324.40). UnitedHealth Group’s IQR is $371.30 ($759.10 - $318.80), the tightest among payers listed here.
Mean rates vary notably: BCBS’s mean is $827.10 and Cigna’s is $754.60, both above the BUCA average, while UnitedHealth Group’s mean is $610.90 and Aetna’s is $501.40, below BUCA. The combination of higher means and larger IQRs for BCBS and Cigna suggests more heterogeneous contracting or regional variation, whereas Aetna and UnitedHealth Group present more concentrated commercial rate distributions around their midpoints.