CPT® Code 59015

1. Indications

The procedure of chorionic villus sampling (CVS) is indicated for several specific reasons, primarily related to the assessment of fetal health and genetic conditions. The following are the explicit indications for performing CVS:

• Genetic Testing CVS is often performed to identify genetic disorders such as Down syndrome, cystic fibrosis, and other chromosomal abnormalities.
• Maternal Age Women of advanced maternal age (typically 35 years or older) may be recommended for CVS due to an increased risk of chromosomal abnormalities in the fetus.
• Family History A family history of genetic disorders may prompt the need for CVS to assess the risk of inherited conditions in the fetus.
• Previous Abnormal Screening Results If prior prenatal screening tests indicate a potential risk for genetic abnormalities, CVS may be indicated for further evaluation.

2. Procedure

The chorionic villus sampling procedure involves several critical steps to ensure the safe and effective collection of placental tissue. The following outlines the procedural steps involved in CVS:

• Step 1: Preparation The physician begins by preparing the patient for the procedure. This includes cleansing the vaginal area and cervix with an antiseptic solution to reduce the risk of infection. The patient may be positioned comfortably to facilitate access to the cervix or abdomen, depending on the chosen method of sampling.
• Step 2: Ultrasonic Guidance Ultrasonic imaging is utilized to visualize the fetus and placenta, ensuring accurate placement of the catheter or needle. This imaging is crucial for guiding the physician during the procedure and minimizing any potential risks to the fetus.
• Step 3: Catheter Insertion (Transvaginal Approach) If the transvaginal approach is selected, the physician carefully inserts a thin catheter through the cervix and into the placenta. The catheter is designed to aspirate placental cells, which are then collected for analysis.
• Step 4: Needle Insertion (Transabdominal Approach) In cases where the transabdominal approach is used, the physician inserts a needle through the abdominal wall and into the placenta. Similar to the transvaginal method, this needle is used to aspirate placental cells, which are then collected for testing.
• Step 5: Sample Collection Once the placental cells are aspirated into the catheter or needle, the physician carefully removes the instrument, ensuring that the sample is preserved for laboratory analysis. The entire procedure is typically completed within a short time frame, minimizing discomfort for the patient.

3. Post-Procedure

After the chorionic villus sampling procedure, patients are usually monitored for a short period to ensure there are no immediate complications. It is common for patients to experience mild cramping or spotting following the procedure, which typically resolves quickly. Patients are advised to rest and may be instructed to avoid strenuous activities for a short period. Follow-up appointments may be scheduled to discuss the results of the genetic testing and any further steps that may be necessary based on those results. It is important for patients to report any unusual symptoms, such as heavy bleeding or severe pain, to their healthcare provider promptly.