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CPT 88261: Chromosome Analysis with Banded Karyotype
CPT code 88261 represents a cytogenetic chromosome analysis in which an analyst examines genetic material, counts five cells, and produces a single banded karyotype image. Chromosome analysis is used to detect numerical and structural chromosomal abnormalities that inform diagnoses in oncology, prenatal testing, congenital anomaly evaluation, and other genetic disorders. Nationally, this code captures an important diagnostic laboratory service with implications for clinical decision-making and downstream genetic counseling and testing.
Key payers covered in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context and typical sites of service, common billing modifiers, and which payers commonly reimburse cytogenetic analyses. The publication outlines benchmarks and payment considerations where available, highlights coding and documentation elements relevant to laboratory workflows, and summarizes policy or coverage trends that could affect utilization and reimbursement. This resource is intended to help revenue cycle, laboratory management, and clinical teams understand how CPT code 88261 is used and where to look for payer-specific policies and coverage guidance.
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Billing Code Overview
CPT code 88261 describes a chromosome analysis performed by a laboratory analyst. The test examines a person’s genetic material for chromosomal abnormalities by counting five cells and producing one karyotype with banding, which is a photographic representation of the chromosomes.
Service type: Cytogenetic laboratory procedure
Typical site of service: Clinical laboratory / hospital laboratory
Data not available in the input for payers, associated taxonomies, ICD-10 diagnoses, and related codes.