How To Use CPT Code 88249

CPT 88249 describes the procedure for chromosome analysis for breakage syndromes, specifically scoring 100 cells for clastogen stress using various methods such as diepoxybutane, mitomycin C, ionizing radiation, or UV radiation. 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 88249?

CPT 88249 can be used to describe the procedure of chromosome analysis for breakage syndromes. It involves scoring 100 cells for clastogen stress using diepoxybutane, mitomycin C, ionizing radiation, UV radiation, or other methods. This test helps reveal underlying genetic disorders by identifying breaks or disorders in chromosomes. Chromosomes are DNA-containing structures found in cells.

2. Official Description

The official description of CPT code 88249 is: ‘Chromosome analysis for breakage syndromes; score 100 cells, clastogen stress (eg, diepoxybutane, mitomycin C, ionizing radiation, UV radiation).’

3. Procedure

1. The lab analyst performs a chromosome analysis for breakage syndromes.
2. He scores 100 cells for clastogen stress using diepoxybutane, mitomycin C, ionizing radiation, UV radiation, or another method.
3. The analyst treats the culture of blood or bone marrow cells with a clastogen, such as mitomycin C, to induce breaks in chromosomes specific to the breakage syndrome being evaluated.
4. He collects cultured cells in metaphase, a stage of cellular division that clearly exhibits the chromosomes.
5. The cells are placed on microscope slides and covered with a stain that reveals the banding pattern of the chromosomes.
6. The analyst then scores 100 cells for the presence of abnormalities indicating breaks in the chromosomes.

4. Qualifying circumstances

CPT 88249 is performed to evaluate a patient’s lymphocytes, which are white blood cells, for breakage syndromes. It is not limited to testing for specific conditions but can be ordered to diagnose breakage syndromes such as Fanconi anemia, a genetic condition characterized by decreased levels of all blood cells and growth impairment.

5. When to use CPT code 88249

CPT code 88249 should be used when performing chromosome analysis for breakage syndromes and scoring 100 cells for clastogen stress. It is important to ensure that the specific clastogen stress method used is documented accurately.

6. Documentation requirements

To support a claim for CPT 88249, the following documentation is required:

• Patient’s diagnosis or reason for performing the test
• Specific clastogen stress method used (eg, diepoxybutane, mitomycin C, ionizing radiation, UV radiation)
• Date of the procedure
• Number of cells scored (100 cells)
• Presence of abnormalities indicating breaks in the chromosomes

7. Billing guidelines

When billing for CPT 88249, ensure that the procedure involves scoring 100 cells for clastogen stress. It is important to accurately report the specific clastogen stress method used. There are no specific guidelines regarding reporting CPT 88249 with other codes.

8. Historical information

CPT 88249 was added to the Current Procedural Terminology system on January 1, 1999. There have been no updates to the code since its addition.

9. Examples

1. A lab analyst performs chromosome analysis for breakage syndromes and scores 100 cells for clastogen stress using diepoxybutane for a patient suspected of having Fanconi anemia.
2. Using mitomycin C, the analyst scores 100 cells for clastogen stress during chromosome analysis for a patient with suspected Bloom syndrome.
3. Ionizing radiation is used to induce breaks in chromosomes, and the analyst scores 100 cells for clastogen stress during chromosome analysis for a patient with suspected Ataxia-telangiectasia.
4. For a patient with suspected Nijmegen breakage syndrome, the analyst uses UV radiation to induce breaks in chromosomes and scores 100 cells for clastogen stress during chromosome analysis.
5. Using another clastogen stress method, such as cisplatin, the analyst scores 100 cells for clastogen stress during chromosome analysis for a patient with suspected Roberts syndrome.