CPT 81512: Multi-Analyte Prenatal Risk Assessment

CPT code 81512 describes a laboratory service in which the lab performs technical testing for five analytes (AFP, uE3, total and hyperglycosylated hCG, and DIA) and applies an algorithmic analysis using patient data and test results to report a patient risk score; this service is a multi-analyte prenatal risk assessment typically provided as a clinical laboratory diagnostic assay and usually performed in a clinical laboratory or reference laboratory setting.

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CPT 81512: Multi-Analyte Prenatal Risk Assessment

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Get alerted when payer policies referencing 81512 are released or updated.

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Clinical & Coding Specifications

Clinical Context

A pregnant patient presents for second-trimester aneuploidy and adverse outcome risk assessment. The laboratory performs maternal serum biomarker testing including alpha-fetoprotein (AFP), unconjugated estriol (uE3), total and hyperglycosylated human chorionic gonadotropin (hCG), and dimeric inhibin A (DIA). Patient demographic and clinical data (gestational age, maternal age, weight, prior obstetric history, and smoking status) are entered into an algorithmic risk-analysis platform. The lab analyst runs the five analyte assays, integrates results with patient variables, and generates a patient-specific risk score for neural tube defects, trisomy 21, trisomy 18, and related pregnancy complications. Results are validated, a final report with the calculated risk score is sent electronically to the ordering obstetrician or maternal-fetal medicine specialist, and documented in the patient chart. Typical workflow steps: collection of maternal blood in an outpatient prenatal clinic or laboratory phlebotomy site; sample transport to a clinical chemistry/laboratory facility; performance of immunoassays and QC; algorithmic analysis to derive the multi-marker risk score; review by laboratory personnel; release of report to the ordering provider and incorporation into prenatal care planning. Typical site of service: outpatient laboratory or hospital clinical laboratory. Service type: clinical laboratory multianalyte algorithmic analysis with report of patient risk score (laboratory analytics/diagnostic testing).

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`81025`	Urinalysis, automated, with microscopy	Performed at prenatal visits to evaluate maternal health and may be ordered concurrently with maternal serum screening.
`36415`	Collection of venous blood by venipuncture	Required to obtain the maternal specimen used for the five-analyte panel.
`83036`	Hemoglobin A1c testing	May be ordered in prenatal care for diabetes screening alongside risk assessment.
`76810`	Ultrasound, obstetric, fetal and maternal assessment	Often used after abnormal serum screening results to perform targeted fetal anatomical assessment.
`58100`	Endometrial sampling (biopsy)	Not routinely part of prenatal screening but listed here as an adjacent procedural code in reproductive care workflows.

Related Modifiers

5 rows

Modifier	Description	When to Use
26	Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…	- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
90	Modifier ‑90 (Reference/Outside Laboratory) indicates that a laboratory test was performed by an entity other than the treating or reporting provider. The American Medical Association defines…	- Use CPT modifier -90 when a laboratory test is performed by an outside/reference laboratory (an entity other than the treating or reporting physician or qualified professional) and the claim needs…
91	Modifier 91 — “Repeat Clinical Diagnostic Laboratory Test” — is appended when the exact same CPT laboratory test is performed more than once for the same patient on the same day because serial,…	- Use modifier 91 when the exact same CPT laboratory test is performed more than once on the same patient on the same date because serial or repeated testing is medically necessary to monitor…
23	Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…	- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
47	Modifier -47 (“Anesthesia by Surgeon”) is appended to a surgical or procedural CPT code when the surgeon personally provides regional or general anesthesia for the procedure. Use of -47 indicates the…	- Use modifier -47 when the surgeon personally provides regional or general anesthesia during the surgical procedure (i.e., the surgeon administers the anesthesia in addition to performing the…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
163W00000X	Registered Nurse	(1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive…
207Q00000X	Family Medicine Physician	Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadt…
207LP2900X	Pain Medicine (Anesthesiology) Physician	An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chr…
207RC0000X	Cardiovascular Disease Physician	An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threaten…
208000000X	Pediatrics Physician	A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectru…
246QH0600X	Histology Specialist/Technologist	Technologists, Technicians & Other Technical Service Providers · Specialist/Technologist, Pathology
261QS0112X	Oral and Maxillofacial Surgery Clinic/Center	The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functi…
156FX1101X	Ophthalmic Assistant	An ophthalmic assistant assists ophthalmologists by performing duties including, but not limited to, patient charting, patient education, and basic ey…

CPT 81490: Serum Biomarker Panel and RA Disease Activity Score

CPT-81493-CORONARY-ARTERY-DISEASE-23-GENE-RT-PCR-RISK-SCORE

CPT 81493: 23-Gene RT-PCR Molecular Test With CAD Risk Score

CPT-81500-CA125-HE4-ALGORITHMIC-RISK-SCORE

CPT 81500: Algorithmic Risk Score Using CA-125 and HE4

CPT-81503-ALGORITHMIC-LAB-RISK-SCORE-CA125-APOLIPOPROTEIN-A1

CPT 81503: Algorithmic Risk Score from Multiple Lab Markers

CPT-81504-TUMOR-ORIGIN-RNA-EXPRESSION-CLASSIFIER

CPT 81504: Tumor RNA Expression Profile Comparison

CPT-81506-DIABETES-BIOMARKER-PANEL-WITH-RISK-SCORE

CPT 81506: Diabetes Risk Score from Biochemical Assays

CPT-81507-NIPS-CELL-FREE-DNA-TRISOMY-RISK-ANALYSIS

CPT 81507: Noninvasive Prenatal Testing for Trisomies 13, 18, 21

CPT-81508-PAPP-A-HCG-ALGORITHMIC-RISK-ASSAY

CPT 81508: First-Trimester PAPP-A and hCG Risk Score

CPT-81509-LAB-ALGORITHMIC-RISK-ASSESSMENT-PAPP-A-HCG-DIA

CPT 81509: Prenatal Biochemical Risk Score from PAPP–A, hCG, DIA

CPT-81510-PRENATAL-TRIPLE-MARKER-ALGORITHMIC-RISK-ASSESSMENT

CPT 81510: Prenatal Serum Screening with Algorithmic Risk Score

Showing 1–10 of 41

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

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Clinical & Coding Specifications

Clinical Context

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`81025`	Urinalysis, automated, with microscopy	Performed at prenatal visits to evaluate maternal health and may be ordered concurrently with maternal serum screening.
`36415`	Collection of venous blood by venipuncture	Required to obtain the maternal specimen used for the five-analyte panel.
`83036`	Hemoglobin A1c testing	May be ordered in prenatal care for diabetes screening alongside risk assessment.
`76810`	Ultrasound, obstetric, fetal and maternal assessment	Often used after abnormal serum screening results to perform targeted fetal anatomical assessment.
`58100`	Endometrial sampling (biopsy)	Not routinely part of prenatal screening but listed here as an adjacent procedural code in reproductive care workflows.

Related Modifiers

5 rows

Modifier	Description	When to Use
26	Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…	- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
90	Modifier ‑90 (Reference/Outside Laboratory) indicates that a laboratory test was performed by an entity other than the treating or reporting provider. The American Medical Association defines…	- Use CPT modifier -90 when a laboratory test is performed by an outside/reference laboratory (an entity other than the treating or reporting physician or qualified professional) and the claim needs…
91	Modifier 91 — “Repeat Clinical Diagnostic Laboratory Test” — is appended when the exact same CPT laboratory test is performed more than once for the same patient on the same day because serial,…	- Use modifier 91 when the exact same CPT laboratory test is performed more than once on the same patient on the same date because serial or repeated testing is medically necessary to monitor…
23	Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…	- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
47	Modifier -47 (“Anesthesia by Surgeon”) is appended to a surgical or procedural CPT code when the surgeon personally provides regional or general anesthesia for the procedure. Use of -47 indicates the…	- Use modifier -47 when the surgeon personally provides regional or general anesthesia during the surgical procedure (i.e., the surgeon administers the anesthesia in addition to performing the…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
163W00000X	Registered Nurse	(1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive…
207Q00000X	Family Medicine Physician	Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadt…
207LP2900X	Pain Medicine (Anesthesiology) Physician	An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chr…
207RC0000X	Cardiovascular Disease Physician	An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threaten…
208000000X	Pediatrics Physician	A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectru…
246QH0600X	Histology Specialist/Technologist	Technologists, Technicians & Other Technical Service Providers · Specialist/Technologist, Pathology
261QS0112X	Oral and Maxillofacial Surgery Clinic/Center	The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functi…
156FX1101X	Ophthalmic Assistant	An ophthalmic assistant assists ophthalmologists by performing duties including, but not limited to, patient charting, patient education, and basic ey…

CPT 81490: Serum Biomarker Panel and RA Disease Activity Score

CPT-81493-CORONARY-ARTERY-DISEASE-23-GENE-RT-PCR-RISK-SCORE

CPT 81493: 23-Gene RT-PCR Molecular Test With CAD Risk Score

CPT-81500-CA125-HE4-ALGORITHMIC-RISK-SCORE

CPT 81500: Algorithmic Risk Score Using CA-125 and HE4

CPT-81503-ALGORITHMIC-LAB-RISK-SCORE-CA125-APOLIPOPROTEIN-A1

CPT 81503: Algorithmic Risk Score from Multiple Lab Markers

CPT-81504-TUMOR-ORIGIN-RNA-EXPRESSION-CLASSIFIER

CPT 81504: Tumor RNA Expression Profile Comparison

CPT-81506-DIABETES-BIOMARKER-PANEL-WITH-RISK-SCORE

CPT 81506: Diabetes Risk Score from Biochemical Assays

CPT-81507-NIPS-CELL-FREE-DNA-TRISOMY-RISK-ANALYSIS

CPT 81507: Noninvasive Prenatal Testing for Trisomies 13, 18, 21

CPT-81508-PAPP-A-HCG-ALGORITHMIC-RISK-ASSAY

CPT 81508: First-Trimester PAPP-A and hCG Risk Score

CPT-81509-LAB-ALGORITHMIC-RISK-ASSESSMENT-PAPP-A-HCG-DIA

CPT 81509: Prenatal Biochemical Risk Score from PAPP–A, hCG, DIA

CPT-81510-PRENATAL-TRIPLE-MARKER-ALGORITHMIC-RISK-ASSESSMENT

CPT 81510: Prenatal Serum Screening with Algorithmic Risk Score

Showing 1–10 of 41

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

OpenPayer

CPT 81512: Multi-Analyte Prenatal Risk Assessment

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OpenPayer

CPT 81512: Multi-Analyte Prenatal Risk Assessment

Sign up for cpt 81512 policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Codes

References

CPT 81512: Multi-Analyte Prenatal Risk Assessment

Sign up for cpt 81512 policy alerts

CPT 81512: Multi-Analyte Prenatal Risk Assessment

Sign up for cpt 81512 policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Codes

What clinical service does CPT 81512 represent and where is it typically performed?

Which billing modifiers are relevant for 81512 and when are they used?

Are there other CPT codes commonly associated with the testing workflow for 81512?

What diagnosis codes are commonly used with CPT 81512?

Which payers are mentioned and does the page provide reimbursement rates or coverage details for 81512?

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Codes

What clinical service does CPT 81512 represent and where is it typically performed?

Which billing modifiers are relevant for 81512 and when are they used?

Are there other CPT codes commonly associated with the testing workflow for 81512?

What diagnosis codes are commonly used with CPT 81512?

Which payers are mentioned and does the page provide reimbursement rates or coverage details for 81512?

References