Summary & Overview
CPT 88235: Amniotic Fluid or Chorionic Villus Tissue Culture for Chromosome Analysis
CPT code 88235 covers the laboratory preparation of tissue cultures from amniotic fluid or chorionic villus cells for nonneoplastic chromosome analysis. This cytogenetic preparatory step is a critical component of prenatal diagnostic workflows, enabling subsequent karyotyping or chromosomal testing that can detect chromosomal abnormalities in the fetus. Nationally, such laboratory services support prenatal care pathways and genetic diagnostic programs across hospitals and reference laboratories.
Key payers in typical analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context and service expectations for CPT code 88235, along with what to expect from payer coverage policies and benchmarking considerations where available. The publication outlines typical sites of service and the role of this cytogenetic procedure in prenatal diagnosis, and it signals areas where policy updates or payer requirements most commonly affect billing and documentation.
The content is intended to help laboratory managers, billing professionals, and policy analysts understand the clinical purpose of CPT code 88235, common billing scenarios, and the types of payer policies that typically govern coverage and reimbursement for prenatal tissue culture services.
Billing Code Overview
CPT code 88235 describes the preparation of a tissue culture for nonneoplastic disorders using amniotic fluid or chorionic villus cells. The procedure involves isolating fetal cells from amniotic fluid or chorionic villi and cultivating them so the cells multiply in tissue culture for subsequent chromosome analysis.
Service type: Cytogenetic tissue culture preparation
Typical site of service: Clinical laboratory or hospital laboratory
Clinical & Coding Specifications
Clinical Context
A pregnant patient undergoes prenatal diagnostic testing after abnormal screening or advanced maternal age. Amniocentesis or chorionic villus sampling (CVS) is performed by an obstetrician or maternal-fetal medicine specialist to obtain amniotic fluid or chorionic villus tissue. The specimen is sent to the cytogenetics laboratory where a lab analyst initiates a tissue culture of fetal cells to expand cell populations for subsequent chromosome analysis, karyotyping, or targeted cytogenetic testing. The clinical workflow includes specimen receipt and accessioning, sterile culture setup, incubation and monitoring for cell growth, harvest of metaphase cells, and preparation of slides for chromosome analysis. Results inform diagnosis of chromosomal aneuploidy or structural abnormalities and are communicated to the ordering clinician for counseling the patient.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the professional interpretation component if split billing applies. |
TC | Technical component | Use when billing only the technical/laboratory component of the test. |