How To Use CPT Code 88261

CPT 88261 describes the process of chromosome analysis, specifically counting five cells and creating one karyotype with banding. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 88261?

CPT 88261 can be used to describe the process of chromosome analysis, where a sample such as whole blood, bone marrow, body fluid, or tissue culture is examined for genetic abnormalities. The analyst performs this analysis by placing actively dividing cells with observable chromosomes on slides and applying special stains to reveal the chromosomes. The analyst then counts five cells, photographs the chromosomes, and arranges them in a karyotype.

2. Official Description

The official description of CPT code 88261 is: ‘Chromosome analysis; count 5 cells, 1 karyotype, with banding.’

3. Procedure

1. The analyst obtains a sample, such as whole blood, bone marrow, body fluid, or tissue culture.
2. Actively dividing cells with observable chromosomes are placed on slides.
3. Special stains are applied to reveal the chromosomes and create banding patterns.
4. The analyst counts five cells and photographs the chromosomes.
5. The chromosomes are arranged in a karyotype, which shows the individual chromosomes from one to 23.

4. Qualifying circumstances

CPT 88261 is typically ordered by clinicians to diagnose genetic abnormalities, such as Down syndrome or Edwards syndrome. It can also be used to detect malignancies like lymphoma. The analysis is performed using samples like whole blood, bone marrow, body fluid, or tissue culture.

5. When to use CPT code 88261

CPT code 88261 should be used when a chromosome analysis is performed, counting five cells and creating one karyotype with banding. It is important to note that this code is not limited to testing for a specific condition, but is commonly used to diagnose genetic abnormalities and malignancies.

6. Documentation requirements

To support a claim for CPT 88261, the documentation should include:

• Patient’s diagnosis or reason for the chromosome analysis
• Type of sample used for the analysis
• Date of the analysis
• Number of cells counted and karyotype created
• Any additional relevant information or findings

7. Billing guidelines

When billing for CPT 88261, ensure that the analysis includes counting five cells and creating one karyotype with banding. It is important to follow the specific guidelines for reporting this code and to consider any additional services or procedures performed in conjunction with the chromosome analysis.

8. Historical information

CPT 88261 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient undergoes chromosome analysis using a bone marrow sample, and the analyst counts five cells and creates one karyotype with banding.
2. A clinician orders a chromosome analysis on a patient’s whole blood sample to diagnose a genetic abnormality, and the analyst counts five cells and creates one karyotype with banding.
3. A patient with suspected lymphoma undergoes chromosome analysis using a tissue culture sample, and the analyst counts five cells and creates one karyotype with banding.
4. A clinician orders a chromosome analysis on a patient’s body fluid sample to investigate a potential genetic abnormality, and the analyst counts five cells and creates one karyotype with banding.
5. A patient undergoes chromosome analysis using a bone marrow sample, and the analyst counts five cells and creates one karyotype with banding.
6. A clinician orders a chromosome analysis on a patient’s whole blood sample to diagnose a genetic abnormality, and the analyst counts five cells and creates one karyotype with banding.
7. A patient with suspected lymphoma undergoes chromosome analysis using a tissue culture sample, and the analyst counts five cells and creates one karyotype with banding.
8. A clinician orders a chromosome analysis on a patient’s body fluid sample to investigate a potential genetic abnormality, and the analyst counts five cells and creates one karyotype with banding.
9. A patient undergoes chromosome analysis using a bone marrow sample, and the analyst counts five cells and creates one karyotype with banding.
10. A clinician orders a chromosome analysis on a patient’s whole blood sample to diagnose a genetic abnormality, and the analyst counts five cells and creates one karyotype with banding.