How To Use CPT Code 81229

CPT 81229 is a code for cytogenomic analysis for constitutional chromosomal abnormalities using comparative genomic hybridization (CGH) microarray analysis. This article will cover the description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 81229.

1. What is CPT 81229?

CPT 81229 is a code used for cytogenomic analysis for constitutional chromosomal abnormalities. This test is performed using comparative genomic hybridization (CGH) microarray analysis, which is a high-resolution evaluation across the entire genome to detect variations in the number of copies of gene sequences and single nucleotide polymorphism (SNP) variants. The test is used to identify genetic changes that may be associated with developmental delays or disabilities.

2. 81229 CPT code description

The official description of CPT code 81229 is: “Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and single nucleotide polymorphism (SNP) variants, comparative genomic hybridization (CGH) microarray analysis.”

3. Procedure

1. The lab analyst extracts DNA from the specimen, such as blood.
2. The DNA is amplified (increased) to prepare for hybridization.
3. The DNA is hybridized to a microscopic array of short, single-stranded nucleic-acid targets across the entire genome.
4. Computer image analysis detects copy-number variants (CNVs) and single nucleotide polymorphism (SNP) variants across the entire genome.
5. The results are used to identify chromosomal abnormalities associated with known conditions.

4. Qualifying circumstances

Individuals eligible to receive CPT 81229 services are those with signs of constitutional developmental delays, intellectual disability, autism spectrum disorder (ASD), and/or congenital anomalies not indicative of a specific genetic disorder. This test is often ordered as an initial evaluation for children with these conditions.

5. When to use CPT code 81229

It is appropriate to bill the 81229 CPT code when a clinician orders a cytogenomic analysis for constitutional chromosomal abnormalities using CGH microarray analysis. This test is typically used as an initial evaluation for children with developmental delays, intellectual disability, autism spectrum disorder, or congenital anomalies not indicative of a specific genetic disorder.

6. Documentation requirements

Documentation to support a claim for CPT 81229 should include the following information:

• Patient’s medical history and presenting symptoms
• Clinical indication for the test
• Test results and interpretation
• Relevant family history, if applicable
• Any additional testing or follow-up recommendations

7. Billing guidelines

When billing for CPT code 81229, keep in mind the following guidelines:

• Do not report CPT 81229 in conjunction with CPT 81228 or CPT 81349.
• Do not report CPT 88271 when performing cytogenomic analysis for constitutional chromosomal abnormalities.
• For genomic sequencing procedures or other molecular multianalyte assays for copy number analysis using circulating cell-free fetal DNA in maternal blood, use CPT 81420, CPT 81422, or CPT 81479.

8. Historical information

CPT 81229 was added to the Current Procedural Terminology system on January 1, 2012. The code was changed on January 1, 2022, from its previous descriptor: “Cytogenomic constitutional (genome-wide) microarray analysis; interrogation of genomic regions for copy number and single nucleotide polymorphism (SNP) variants for chromosomal abnormalities.”

9. Similar codes to CPT 81229

Five similar codes to CPT 81229 and how they differentiate are:

1. CPT 81228: This code is for a targeted cytogenomic analysis for chromosomal abnormalities, not genome-wide.
2. CPT 81349: This code is for a targeted analysis of specific genomic regions for copy number and SNP variants.
3. CPT 81420: This code is for genomic sequencing procedures for copy number analysis using circulating cell-free fetal DNA in maternal blood.
4. CPT 81422: This code is for genomic sequencing procedures for targeted copy number analysis using circulating cell-free fetal DNA in maternal blood.
5. CPT 81479: This code is for unlisted molecular multianalyte assays for copy number analysis using circulating cell-free fetal DNA in maternal blood.

10. Examples

Here are 10 detailed examples of CPT code 81229 procedures:

1. A child with developmental delays and no known genetic disorder undergoes CPT 81229 testing to identify potential chromosomal abnormalities.
2. A child with autism spectrum disorder and intellectual disability undergoes CPT 81229 testing to help guide diagnosis and treatment planning.
3. A child with multiple congenital anomalies not indicative of a specific genetic disorder undergoes CPT 81229 testing to identify potential chromosomal abnormalities.
4. A child with a family history of intellectual disability undergoes CPT 81229 testing to determine if they have inherited a chromosomal abnormality.
5. A child with developmental delays and a history of seizures undergoes CPT 81229 testing to identify potential chromosomal abnormalities that may be contributing to their condition.
6. A child with autism spectrum disorder and a family history of the disorder undergoes CPT 81229 testing to identify potential inherited chromosomal abnormalities.
7. A child with developmental delays and a history of failure to thrive undergoes CPT 81229 testing to identify potential chromosomal abnormalities that may be contributing to their condition.
8. A child with intellectual disability and a history of speech and language delays undergoes CPT 81229 testing to identify potential chromosomal abnormalities that may be contributing to their condition.
9. A child with autism spectrum disorder and a history of sensory processing difficulties undergoes CPT 81229 testing to identify potential chromosomal abnormalities that may be contributing to their condition.
10. A child with developmental delays and a history of motor skill difficulties undergoes CPT 81229 testing to identify potential chromosomal abnormalities that may be contributing to their condition.