How To Use CPT Code 81508

CPT 81508 describes the biochemical assays of two proteins, PAPP-A and hCG, in maternal serum to assess the risk of fetal congenital abnormalities. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 81508?

CPT 81508 can be used to describe the biochemical assays of two proteins, PAPP-A and hCG, in maternal serum. These assays are performed to assess the risk of fetal congenital abnormalities. The lab analyst performs the technical lab tests for these proteins and carries out an algorithmic analysis using patient data and the lab test results to report a patient risk score.

2. Official Description

The official description of CPT code 81508 is: ‘Fetal congenital abnormalities, biochemical assays of two proteins (PAPP-A, hCG [any form]), utilizing maternal serum, algorithm reported as a risk score.’

3. Procedure

1. The lab analyst performs biochemical assays for two proteins, PAPP-A and hCG, in maternal serum.
2. The lab analyst inputs the test results into a computer program to analyze the data using a specific algorithm.
3. The algorithmic analysis takes into account patient data and the lab test results to calculate a risk score for fetal congenital abnormalities.
4. The lab analyst reports the risk score to the healthcare provider.

4. Qualifying circumstances

CPT 81508 is used when biochemical assays of two proteins, PAPP-A and hCG, are performed in maternal serum to assess the risk of fetal congenital abnormalities. This test is typically ordered by clinicians to screen for conditions such as Down syndrome (trisomy 21) in the first trimester of pregnancy.

5. When to use CPT code 81508

CPT code 81508 should be used when performing biochemical assays of PAPP-A and hCG in maternal serum to assess the risk of fetal congenital abnormalities. It is important to note that CPT code 81508 should not be reported in conjunction with CPT codes 84163 and 84702.

6. Documentation requirements

To support a claim for CPT code 81508, the following documentation is required:

• Indication for the test, such as screening for fetal congenital abnormalities
• Results of the biochemical assays for PAPP-A and hCG
• Algorithmic analysis and the reported risk score

7. Billing guidelines

When billing for CPT code 81508, it is important to note that Medicare and some other payers do not accept MAAA codes. Therefore, it is recommended to bill only the underlying test codes, such as CPT codes 84163 and 84702. Do not report CPT code 81508 in addition to these codes.

8. Historical information

CPT code 81508 was added to the Current Procedural Terminology system on January 1, 2013. There have been no updates to the code since its addition.

9. Examples

1. A pregnant woman undergoes biochemical assays of PAPP-A and hCG in her maternal serum to assess the risk of fetal congenital abnormalities.
2. A healthcare provider orders the biochemical assays of PAPP-A and hCG for a pregnant patient to screen for Down syndrome in the first trimester.
3. A lab analyst performs the biochemical assays of PAPP-A and hCG in maternal serum and reports a risk score for fetal congenital abnormalities.
4. A pregnant woman receives a risk score for fetal congenital abnormalities based on the biochemical assays of PAPP-A and hCG in her maternal serum.
5. A healthcare provider uses the risk score obtained from the biochemical assays of PAPP-A and hCG to guide further diagnostic testing for fetal congenital abnormalities.
6. A lab technician inputs the results of the biochemical assays of PAPP-A and hCG into a computer program to calculate a risk score for fetal congenital abnormalities.
7. A pregnant patient undergoes biochemical assays of PAPP-A and hCG in her maternal serum as part of routine prenatal screening.
8. A healthcare provider discusses the results of the biochemical assays of PAPP-A and hCG with a pregnant patient to provide information about the risk of fetal congenital abnormalities.
9. A lab analyst performs the biochemical assays of PAPP-A and hCG in maternal serum and generates a risk score for fetal congenital abnormalities.
10. A pregnant woman receives a risk score for fetal congenital abnormalities based on the biochemical assays of PAPP-A and hCG performed on her maternal serum.