Summary & Overview
CPT 88130: Sex Chromatin (Barr Body) Analysis
CPT code 88130 represents a technical laboratory procedure to analyze sex chromatin (Barr bodies) in cells to assist in determining chromosomal sex. As a specialized cytogenetic/clinical laboratory test, it is ordered when cellular-level assessment of sex chromosomes is clinically relevant. Nationally, the code matters because it captures a distinct laboratory service with implications for clinical diagnosis, gender-related evaluations, and downstream genetic or endocrine workups. Key payers in the national landscape include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find a concise overview of what CPT code 88130 covers, the clinical context in which the test is used, and the typical sites where the service is performed. The publication provides benchmark and coverage context for major payers, notes common billing modifiers and procedural components where applicable, and summarizes policy and coding considerations that affect reimbursement and claims submission. The content is geared toward clinicians, laboratory managers, and coding professionals seeking a clear, national-level understanding of the code, its clinical role, and administrative considerations. Data not available in the input is noted where applicable for readers seeking payer-specific rates or utilization metrics.
Billing Code Overview
CPT code 88130 describes a laboratory technical procedure in which a lab analyst evaluates sex chromatin in cells to detect the presence of Barr bodies. The test is used to help determine chromosomal sex by identifying nuclear chromatin patterns associated with the inactive X chromosome.
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Service type: Clinical laboratory analysis of cellular sex chromatin
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Typical site of service: Clinical laboratory or hospital laboratory setting
Clinical & Coding Specifications
Clinical Context
A cytogenetics laboratory receives a peripheral blood sample from a pediatrics clinic to evaluate a newborn with ambiguous external genitalia. The lab technician performs 88130 sex chromatin (Barr body) analysis as a technical test to stain interphase nuclei and assess the presence or absence of Barr bodies, which may help determine the likely chromosomal sex (presence of inactive X chromosomes).
Typical workflow: the ordering clinician (pediatrician or neonatologist) requests testing to assist in sex determination. The specimen (usually blood or buccal smear) is accessioned into the lab, processed, fixed, and stained for sex chromatin. A trained laboratory analyst performs the microscopic technical component, documents slide counts and staining quality, and prepares a technical report. If a professional (interpretive) component is required, a pathologist or clinical cytogeneticist reviews slides and issues an interpretive report billed separately. Results are communicated to the ordering clinician for integration with physical exam, imaging, hormonal studies, and definitive karyotyping when indicated.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the interpretive/reporting component by a physician for the test. |