Summary & Overview
CPT 88271: Molecular Cytogenetic Test Using DNA Probe Methods
CPT code 88271 represents molecular cytogenetic testing using DNA probe methods, most commonly fluorescence in situ hybridization (FISH), to evaluate cells for genetic abnormalities such as chromosomal rearrangements, amplifications, or deletions. This test informs diagnosis, prognosis, and treatment planning across oncology, hematology, and genetic disease management, making it a critical laboratory service in modern precision medicine.
Key payers in the national discussion include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines payer coverage patterns and benchmarking context for these major payers. Readers will find a concise clinical context for the test, typical sites of service, common billing considerations, and an overview of what benchmarks and policy topics are relevant to reimbursement and utilization.
The report provides benchmarks for utilization and reimbursement where available, highlights recent policy updates that affect molecular cytogenetic testing, and summarizes clinical situations driving demand for 88271 services. Data not provided in the input — such as specific payer rates, ICD-10 mappings, and associated taxonomies — are noted as unavailable. The content is intended for national audiences including laboratory administrators, billing professionals, and policy analysts seeking an up-to-date briefing on CPT code 88271 and its role in clinical diagnostics.
Billing Code Overview
CPT code 88271 describes a molecular cytogenetic test using DNA probe methods, such as fluorescence in situ hybridization (FISH), performed to detect genetic abnormalities in cells. The procedure involves analysis of cellular DNA with labeled probes to identify chromosomal rearrangements, amplifications, deletions, or other genomic alterations.
Service Type: Molecular cytogenetic testing (DNA probe methods, e.g., FISH)
Typical Site of Service: Clinical laboratory or pathology laboratory; performed on specimens collected from hospital, outpatient clinic, or ambulatory surgical settings
Clinical & Coding Specifications
Clinical Context
A 42-year-old adult female presents with persistent abnormal uterine bleeding and a pelvic mass on ultrasound. The gynecologist performs an endometrial biopsy and orders molecular cytogenetic testing to evaluate for chromosomal rearrangements associated with malignancy. Tissue is sent to the molecular pathology laboratory where a cytogenetics technologist or molecular analyst performs a fluorescence in situ hybridization test to detect target gene amplifications, deletions, or translocations. Results are reviewed by a board-certified pathologist and reported to the ordering provider. Typical workflow steps include specimen accessioning, slide preparation, probe hybridization, fluorescent microscopy, image capture and analysis, result interpretation, and final reporting.
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Service Type: Molecular cytogenetic testing (laboratory-based diagnostic test using DNA probe methods such as FISH).
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Typical Site of Service: Hospital outpatient laboratory or independent reference molecular pathology laboratory; may originate from outpatient clinic, inpatient service, or ambulatory surgical center specimen collection.
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Typical Patient Scenario: Adult patient with suspected neoplasm (solid tumor or hematologic malignancy) or congenital chromosomal abnormality requiring targeted detection of gene rearrangements, copy-number changes, or marker chromosomes to guide diagnosis, prognosis, or therapy selection.
Coding Specifications
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