© Copyright 2025 American Medical Association. All rights reserved.
The CPT® Code 81509 refers to a specific laboratory test that assesses the risk of fetal congenital abnormalities through biochemical assays of three proteins found in maternal serum. This test measures the levels of pregnancy-associated plasma protein A (PAPP-A), human chorionic gonadotropin (hCG) in any form, and Inhibin A Dimer (DIA). The primary purpose of this blood test is to evaluate the risk for certain chromosomal abnormalities, notably trisomy 18 and trisomy 21, which is also known as Down syndrome. The test is most effective when conducted during a specific window of gestation, particularly between 15 weeks and 22 weeks and 6 days. During this period, the sensitivity of the test results is maximized, allowing for a more accurate risk assessment. The blood sample required for this test is obtained through a procedure known as venipuncture, which is separately reportable. The serum collected is then analyzed using a quantitative chemiluminescent immunoassay, a sophisticated laboratory technique that quantifies the proteins in the serum to generate a risk score based on the algorithm utilized in the analysis.
© Copyright 2025 Coding Ahead. All rights reserved.
The CPT® Code 81509 is indicated for use in the assessment of risk for fetal congenital abnormalities, specifically targeting the detection of chromosomal conditions such as trisomy 18 and trisomy 21 (Down syndrome). This test is particularly relevant for pregnant individuals who may be at increased risk for these conditions based on various factors, including maternal age and family history.
The procedure for CPT® Code 81509 involves several key steps to ensure accurate measurement of the specified proteins in maternal serum. First, a qualified healthcare professional performs a venipuncture to obtain a blood sample from the pregnant individual. This step is crucial as it allows for the collection of maternal serum, which is necessary for the subsequent analysis. The timing of the blood draw is essential; the sample should ideally be collected between 15 weeks, 0 days and 22 weeks, 6 days of gestation to achieve optimal sensitivity in the test results.
After the procedure, the patient may experience minimal discomfort at the venipuncture site, which typically resolves quickly. There are no specific post-procedure care requirements beyond standard care for a blood draw. The results of the test are usually communicated to the patient within a few days, and healthcare providers will discuss the implications of the risk score with the patient, including any potential follow-up testing or counseling that may be necessary based on the results.
| Short Descr | FTL CGEN ABNOR 3 PROTEINS | Medium Descr | FETAL CONGENITAL ABNOR ASSAY 3 PROTEINS | Long Descr | Fetal congenital abnormalities, biochemical assays of three proteins (PAPP-A, hCG [any form], DIA), utilizing maternal serum, algorithm reported as a risk score | 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 | Conditionally packaged laboratory tests | Type of Service (TOS) | 5 - Diagnostic Laboratory | Berenson-Eggers TOS (BETOS) | T1H - Lab tests - other (non-Medicare fee schedule) | MUE | 1 | CCS Clinical Classification | 234 - Pathology |
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| 2013-01-01 | Added | Added |