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    OpenPayerBilling CodesFluid washings, Hybridization and Sex Chromatin Identification ProceduresCPT cpt-88140-peripheral-blood-smear-sex-chromatin-identification
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    CPT 88140: Peripheral Blood Smear for Sex Chromatin Identification

    CPT code 88140 describes a laboratory technical service analyzing a peripheral blood smear to identify polymorphonuclear drumsticks (sex chromatin) within neutrophils for sex chromatin identification; service type: microscopic cytologic analysis/hematopathology test; typical site of service: clinical laboratory or hospital laboratory where a trained lab analyst performs the smear preparation and microscopic evaluation.

    For related coverage guidance, see recent payer policy updates: Automated Ambulatory Blood Pressure Monitoring for Diagnosis of Hypertension in Patients with Elevated Office Blood Pressure, Cardiology - Ivabradine, Cardiac Computed Tomography (CCT)/Coronary Computed Tomographic Angiography (CCTA).

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    Clinical & Coding Specifications

    Clinical Context

    A 28-year-old individual assigned female at birth presents to an outpatient hematology laboratory after a primary care provider orders sex chromatin testing to help clarify unexpected karyotype findings from prior prenatal screening or to evaluate disorders of sexual development. The patient has a recent complete blood count with differential and a peripheral blood smear obtained by venipuncture. The laboratory technologist prepares and stains the peripheral smear (e.g., Wright-Giemsa) and the lab analyst performs a microscopic evaluation to identify polymorphonuclear "drumstick" nuclear appendages (Barr bodies) for sex chromatin identification. Results are reported to the ordering clinician and incorporated into the patient’s chart. Typical site of service is an outpatient clinical laboratory or hospital laboratory under physician or clinical laboratory director oversight. Specimen handling, staining, microscopic examination, interpretation, and reporting follow institutional laboratory protocols and CLIA regulations.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    81001Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, specific gravity, etc., non-automated, with microscopyOften performed in parallel during workup of systemic disorders affecting blood cells or sex chromosome anomalies when broader metabolic or renal screening is indicated.
    85025Blood count; complete (CBC) automated and automated differential WBC countFrequently ordered before or with a peripheral smear to assess white cell morphology and counts that prompt smear review.
    85060Blood smear interpretation by a physician with written reportPerformed when a physician issues a formal interpretive report after microscopic review, often billed in conjunction with the technical smear work.
    88232Analysis of tissue by cytogenetic technique, biopsy culture, etc.Performed in cases requiring cytogenetic studies beyond smear sex chromatin identification, such as karyotyping or FISH.
    88271Microarray analysis, genomic copy number and single nucleotide polymorphism genome-wide; patient-level raw and interpreted dataUsed when more detailed chromosomal analysis is required following abnormal sex chromatin findings.

    Related Modifiers

    5 rows

    ModifierDescriptionWhen to Use
    26Modifier 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…
    90Modifier ‑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…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207Q00000X
    207R00000X
    2080P0204X
    222Z00000X
    207UN0903X
    213ES0103X
    363LA2200X
    103T00000X

    Related Payer Policy Updates

    Specialty: Cardiology1 / 3

    10 rows

    PolicyPayerEffective Date
    Automated Ambulatory Blood Pressure Monitoring for Diagnosis of Hypertension in Patients with Elevated Office Blood PressureBluecross Idaho2026-11-01
    Cardiology - IvabradineCigna2026-10-15
    Cardiac Computed Tomography (CCT)/Coronary Computed Tomographic Angiography (CCTA)univerahealthcare2026-10-15
    Percutaneous Ventricular Assist DeviceUnitedHealthcare2026-10-01
    Cardiovascular Disease Risk AssessmentOscar Health2026-10-01
    Biomarkers for Myocardial Infarction and Chronic Heart FailureOscar Health2026-10-01
    Multiple Procedure Payment Reduction for Diagnostic Cardiovascular ProceduresBlue Cross Blue Shield - Maine2026-10-01
    Left Atrial Appendage Closure Devicesexcellus_health_plan_inc2026-09-17
    Left Atrial Appendage Closure Devicesuniverahealthcare2026-09-17
    Cardiac Omnibus CodesCigna2026-09-15

    Related Codes

    CPT-88104-CYTOPATHOLOGY-SMEAR-PREP-AND-INTERPRETATION

    CPT 88104: Cytopathology Smear Preparation and Interpretation

    CPT-88106-NON-GYNECOLOGIC-CYTOPATHOLOGY-SMEAR-SIMPLE-FILTER

    CPT 88106: Cytopathology Smear of Non-Cervical Fluids

    CPT-88108-CYTOPATHOLOGY-FLUID-SMEAR-CONCENTRATION-TECHNIQUE

    CPT 88108: Cytopathology Concentration Smear Preparation and Interpretation

    CPT-88112-LIQUID-BASED-CYTOPATHOLOGY-SELECTIVE-CELLULAR-ENHANCEMENT

    CPT 88112: Selective Cellular Enhancement for Cytopathology

    CPT-88120-URINARY-TRACT-IN-SITU-HYBRIDIZATION-MORPHOMETRIC-ANALYSIS

    CPT 88120: In Situ Hybridization on Urinary Tract Specimen, 3–5 Probes

    CPT-88121-URINARY-TRACT-IN-SITU-HYBRIDIZATION-MORPHOMETRY

    CPT 88121: Urine In Situ Hybridization with 3–5 Probes

    CPT-88125-FORENSIC-CYTOPATHOLOGY-TECHNICAL-SERVICE

    CPT 88125: Cytopathology Specimen Analysis for Forensic Testing

    CPT-88130-SEX-CHROMATIN-BARR-BODY-ANALYSIS

    CPT 88130: Sex Chromatin (Barr Body) Analysis

    Frequently Asked Questions

    References

    1. 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. 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. 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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