CPT® Code 81266 | Case2Code

Official Description

Comparative analysis using Short Tandem Repeat (STR) markers; each additional specimen (eg, additional cord blood donor, additional fetal samples from different cultures, or additional zygosity in multiple birth pregnancies) (List separately in addition to code for primary procedure)

Common Language Description

The CPT® Code 81266 pertains to a specific type of molecular genetic testing that utilizes Comparative analysis through Short Tandem Repeat (STR) markers. This procedure is essential for identifying genetic similarities and differences between individuals, particularly in scenarios involving organ or tissue transplants, as well as in prenatal testing. STR markers are sequences of DNA that consist of repeating units of two or more nucleotides, which are typically located in the non-coding regions of genes, known as introns. These markers are crucial for various applications, including documenting engraftment in transplant recipients and detecting any residual disease post-transplant. In the context of prenatal testing, STR markers can be analyzed from fetal cells obtained through procedures such as amniocentesis or chorionic villus sampling. The analysis involves comparing these markers with those from a maternal blood sample to ensure that the fetal cells are not contaminated by maternal cells, which is vital for accurate genetic assessment. The code 81266 is specifically used to report each additional specimen analyzed, such as additional cord blood donors, fetal samples from different cultures, or additional zygosity assessments in cases of multiple births. This allows for comprehensive genetic comparisons and enhances the accuracy of genetic testing outcomes.

1. Indications

The procedure associated with CPT® Code 81266 is indicated for various scenarios where comparative genetic analysis is necessary. The following conditions and situations warrant the use of this testing:

Additional Cord Blood Donor Analysis This is performed when there are multiple cord blood donors available for a transplant, allowing for a thorough comparison of genetic markers to ensure compatibility.
Fetal Sample Analysis from Different Cultures This is indicated when multiple fetal samples are obtained from different cultures, enabling the assessment of genetic similarities or differences across these samples.
Multiple Birth Zygosity Assessment This is relevant in cases of multiple births, where determining whether twins or higher-order multiples are identical (monozygotic) or fraternal (dizygotic) is crucial for genetic counseling and management.

2. Procedure

The procedure for CPT® Code 81266 involves several key steps to ensure accurate comparative analysis using STR markers. Each step is critical for obtaining reliable results:

Specimen Collection The first step involves the collection of specimens from the relevant individuals. This may include cord blood from donors, fetal samples obtained through amniocentesis or chorionic villus sampling, and maternal blood samples. Proper collection techniques are essential to avoid contamination and ensure the integrity of the samples.
DNA Extraction Once the specimens are collected, DNA is extracted from each sample. This process involves breaking down the cellular structure to isolate the DNA, which is necessary for subsequent analysis. The quality and quantity of the extracted DNA are critical for the accuracy of the testing.
STR Marker Analysis The extracted DNA is then analyzed for specific STR markers. This involves using polymerase chain reaction (PCR) techniques to amplify the regions of interest within the DNA. The amplified DNA is then subjected to electrophoresis, allowing for the visualization and comparison of the STR patterns between the samples.
Data Interpretation After the analysis, the results are interpreted to determine the genetic relationships between the specimens. This includes assessing the presence or absence of specific STR markers and comparing the patterns to identify any genetic similarities or differences.

3. Post-Procedure

Post-procedure care for patients undergoing testing associated with CPT® Code 81266 typically involves monitoring for any potential complications related to the specimen collection, especially in prenatal testing scenarios. Patients may be advised to follow up with their healthcare provider to discuss the results of the genetic analysis. It is also important to provide genetic counseling to help interpret the findings and understand their implications for the individuals involved, particularly in cases of zygosity assessment or donor-recipient compatibility. Additionally, documentation of the results and any recommendations for further testing or interventions should be maintained for future reference.

Short Descr	STR MARKERS SPEC ANAL ADDL
Medium Descr	COMPARATIVE ANAL STR MARKERS EA ADDL SPECIMEN
Long Descr	Comparative analysis using Short Tandem Repeat (STR) markers; each additional specimen (eg, additional cord blood donor, additional fetal samples from different cultures, or additional zygosity in multiple birth pregnancies) (List separately in addition to code for primary procedure)
Status Code	Statutory Exclusion (from MPFS, may be paid under other methodologies)
Global Days	XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC)	9 - Not Applicable
Multiple Procedures (51)	9 - Concept does not apply.
Bilateral Surgery (50)	9 - Concept does not apply.
Physician Supervisions	09 - Concept does not apply.
Assistant Surgeon (80, 82)	9 - Concept does not apply.
Co-Surgeons (62)	9 - Concept does not apply.
Team Surgery (66)	9 - Concept does not apply.
Diagnostic Imaging Family	99 - Concept Does Not Apply
CLIA Waived (QW)	No
APC Status Indicator	Service Paid under Fee Schedule or Payment System other than OPPS
Type of Service (TOS)	5 - Diagnostic Laboratory
Berenson-Eggers TOS (BETOS)	T1H - Lab tests - other (non-Medicare fee schedule)
MUE	2
CCS Clinical Classification	234 - Pathology

This is an add-on code that must be used in conjunction with one of these primary codes.

81265

Resequenced Code MPFS Status: Statutory exclusion (from MPFS, may be paid under other methodologies) APC A Comparative analysis using Short Tandem Repeat (STR) markers; patient and comparative specimen (eg, pre-transplant recipient and donor germline testing, post-transplant non-hematopoietic recipient germline [eg, buccal swab or other germline tissue sample] and donor testing, twin zygosity testing, or maternal cell contamination of fetal cells)