Summary & Overview
CPT 84112: Amniotic Fluid Protein Test for PROM
CPT code 84112 represents a laboratory assay that tests cervicovaginal fluid for amniotic fluid proteins to help identify premature rupture of membranes (PROM) in pregnant patients. This diagnostic procedure informs time-sensitive obstetric decisions such as monitoring, infection prevention, and delivery planning, making it a clinically significant code in maternity care.
Key national payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, typical sites of service, and payer coverage patterns. The publication outlines reimbursement benchmarks, common billing considerations, and recent policy or coding guidance that affect claim adjudication for this test.
This summary equips billing managers, laboratory directors, and obstetric clinicians with practical insights into how CPT code 84112 is used in clinical workflows, where it is typically performed, and the policy factors that influence coverage and payment. Data not available in the input are noted where applicable, and the report focuses on nationally relevant information rather than state-specific rules.
Billing Code Overview
CPT code 84112 describes a laboratory test of cervicovaginal fluid for the presence of amniotic fluid proteins, used to evaluate suspected premature rupture of membranes (PROM) in a pregnant patient. This diagnostic assay assesses whether amniotic fluid has leaked into the vaginal canal, assisting clinical decision-making about maternal and fetal management.
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Service type: Laboratory diagnostic test for pregnancy-related membrane integrity
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Typical site of service: Obstetrics clinic, labor and delivery unit, hospital outpatient laboratory, or other clinical settings where prenatal diagnostic testing is performed
Clinical & Coding Specifications
Clinical Context
A 32-year-old pregnant patient at 36 weeks' gestation presents to the obstetric triage unit with a chief complaint of vaginal fluid leakage and intermittent contractions. The obstetric nurse performs a focused history and a sterile speculum exam to assess for pooling of fluid in the vaginal vault. A cervicovaginal sample is collected and sent for testing of amniotic fluid proteins to evaluate for premature rupture of membranes (PROM). Results are used along with maternal vital signs, fetal heart rate monitoring, and a sterile speculum exam to determine management: expectant outpatient observation, inpatient monitoring with antibiotics and corticosteroids, or induction of labor depending on gestational age, signs of infection, and fetal status. Typical site of service is an outpatient obstetrics clinic, labor and delivery triage, or hospital outpatient department where specimen collection and rapid laboratory or point-of-care testing can be performed. The service type is diagnostic laboratory testing of cervicovaginal fluid for amniotic fluid proteins (PROM evaluation).
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Normal, primary service | When this test is the primary service provided during the encounter |
22 |