How To Use CPT Code 0254U

CPT 0254U describes the analysis of 24 chromosomes using embryonic DNA genomic sequence analysis for aneuploidy, and a mitochondrial DNA score in euploid embryos. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 0254U?

CPT 0254U can be used to analyze the chromosomal abnormalities in embryos using next generation sequencing (NGS) and mitochondrial DNA scoring. This code is specifically designed for the SMART PGT-A (Preimplantation Genetic Testing – Aneuploidy) test from Igenomix® USA. The test evaluates the embryo biopsy to identify abnormalities such as monosomy, trisomy, partial deletion/duplication, mosaicism, and segmental aneuploidy.

2. Official Description

The official description of CPT code 0254U is: ‘Reproductive medicine (preimplantation genetic assessment), analysis of 24 chromosomes using embryonic DNA genomic sequence analysis for aneuploidy, and a mitochondrial DNA score in euploid embryos, results reported as normal (euploidy), monosomy, trisomy, or partial deletion/duplication, mosaicism, and segmental aneuploidy, per embryo tested.’

3. Procedure

1. The lab analyst performs the SMART PGT-A test using a trophectoderm embryo biopsy.
2. The test utilizes next generation sequencing (NGS) to evaluate the genomic sequence of embryonic DNA for abnormalities in 24 chromosomes.
3. The test also includes a mitochondrial DNA score, which indicates the energy status of the embryo.
4. The results of the test are reported as normal (euploidy), monosomy, trisomy, partial deletion/duplication, mosaicism, or segmental aneuploidy for each embryo tested.

4. Qualifying circumstances

CPT 0254U is typically ordered for patients undergoing in vitro fertilization (IVF) to evaluate all embryos from a treatment cycle. The test helps select the most viable embryos for transfer and reduces the risk of miscarriage. It is important to note that this code is specific to the SMART PGT-A test from Igenomix® USA and should not be used for other tests assessing fetal aneuploidy.

5. When to use CPT code 0254U

CPT code 0254U should be used when the SMART PGT-A test from Igenomix® USA is performed to analyze the chromosomal abnormalities in embryos. It is important to ensure that the test is performed on a single specimen analyzed on a single date of service. This code should not be reported for any other tests or procedures.

6. Documentation requirements

To support a claim for CPT code 0254U, the following documentation is required:

• Indication for the SMART PGT-A test and the reason for performing it
• Date of service and the specific test performed
• Results of the analysis, including the chromosomal abnormalities identified and the mitochondrial DNA score
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT code 0254U, ensure that the test is performed by Igenomix® USA for the SMART PGT-A analysis. Report one unit of this code for each individual embryo tested. It is important to distinguish this code from other tests for fetal aneuploidy assessment, such as CPT codes 0168U and 81507. Follow the specific guidelines provided by the payer regarding the use of proprietary laboratory analyses (PLA) codes.

8. Historical information

CPT code 0254U, the SMART PGT-A test from Igenomix® USA, was added to the Current Procedural Terminology system on July 1, 2021. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient undergoing IVF has their embryos analyzed using the SMART PGT-A test from Igenomix® USA to identify any chromosomal abnormalities.
2. A couple with a history of recurrent miscarriages opts for the SMART PGT-A test from Igenomix® USA to select the most viable embryos for transfer during their IVF treatment.
3. A patient with a known genetic disorder undergoes the SMART PGT-A test from Igenomix® USA to ensure that only embryos without the genetic disorder are transferred.
4. A fertility specialist recommends the SMART PGT-A test from Igenomix® USA for a patient with advanced maternal age to assess the chromosomal health of their embryos.
5. A couple with a family history of a specific genetic condition chooses the SMART PGT-A test from Igenomix® USA to screen their embryos for the presence of the genetic condition.
6. A patient with a previous unsuccessful IVF cycle undergoes the SMART PGT-A test from Igenomix® USA to improve the chances of a successful pregnancy by selecting the most viable embryos.
7. A fertility clinic offers the SMART PGT-A test from Igenomix® USA as part of their comprehensive IVF treatment package to ensure the best possible outcomes for their patients.
8. A patient with a history of multiple failed IVF cycles undergoes the SMART PGT-A test from Igenomix® USA to identify any chromosomal abnormalities that may be contributing to the unsuccessful outcomes.
9. A couple with a known genetic disorder in their family chooses the SMART PGT-A test from Igenomix® USA to avoid passing on the genetic condition to their offspring.
10. A patient with a history of recurrent pregnancy loss undergoes the SMART PGT-A test from Igenomix® USA to identify any chromosomal abnormalities that may be contributing to the miscarriages.