Summary & Overview
CPT 88269: In Situ Chromosome Analysis of Cultured Amniotic Fluid Cells
CPT code 88269 designates an in situ chromosome analysis of cultured amniotic fluid cells, including counting cells from six to 12 colonies and preparing one banded karyotype. This cytogenetic test is a key prenatal diagnostic service used to detect fetal chromosomal abnormalities and guide clinical decision-making. Nationally, coverage and reimbursement for cytogenetic procedures like 88269 affect access to prenatal diagnostic services and laboratory resource allocation. Key payers addressed 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 the operational elements of performing in situ amniotic cell chromosome analysis. The publication covers payer coverage patterns and benchmarks where available, common billing considerations, and coding relationships relevant to laboratory and hospital billing workflows. It also outlines implications for laboratory capacity and coding compliance. Data not available in the input is noted where applicable. This summary is intended for a national audience of billing professionals, laboratory managers, and policy analysts.
Billing Code Overview
CPT code 88269 describes a chromosome analysis of cultured amniotic fluid cells performed in situ. The procedure involves an analyst examining cells directly on the surface where they grow, counting cells from six to 12 colonies, and preparing one karyotype with banding. This analysis is used to evaluate fetal chromosomes for numeric and structural abnormalities.
Service Type: Cytogenetic analysis / diagnostic laboratory service
Typical Site of Service: Clinical laboratory or hospital laboratory with cell culture and cytogenetics capability
Clinical & Coding Specifications
Clinical Context
A pregnant patient at 15–20 weeks gestation undergoes diagnostic amniocentesis after abnormal prenatal screening results (for example, abnormal first- or second‑trimester serum screen, abnormal cell‑free DNA, or ultrasound finding such as increased nuchal translucency or major structural anomaly). Amniotic fluid is collected by an obstetrician or maternal‑fetal medicine specialist and sent to a cytogenetics laboratory. In the lab, a cytogenetics analyst performs in situ chromosome analysis of cultured amniotic fluid cells: colonies are grown on a surface, cells from six to 12 colonies are counted, and a single banded karyotype is prepared and interpreted. The workflow includes specimen accessioning, culture setup, cell harvesting and fixation on slides, banding (typically G‑banding), microscopic analysis, karyotype assembly, interpretation, and generation of a written report. Results guide prenatal counseling regarding chromosomal aneuploidy or structural rearrangements and may prompt additional testing such as microarray or targeted molecular tests.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Office or other outpatient service component | Use when the procedure is performed under usual, uncomplicated circumstances in an outpatient cytogenetics laboratory setting |
26 |