CPT® Code 81511

1. Indications

The CPT® Code 81511 is indicated for use in the following scenarios:

• Assessment of Fetal Risk This test is performed to evaluate the risk of fetal congenital abnormalities, including chromosomal conditions such as trisomy 18 and trisomy 21 (Down syndrome).
• Detection of Open Neural Tube Defects The assay helps in identifying the risk of open neural tube defects, such as spina bifida.
• Evaluation of Pregnancy Outcomes It is utilized to assess the likelihood of adverse pregnancy outcomes, including the potential for pregnancy failure to carry to term or complications during term gestation.
• Screening for Preeclampsia The test aids in determining the risk of developing preeclampsia during pregnancy.
• Identification of Gestational Trophoblastic Disease It is also indicated for evaluating the risk of gestational trophoblastic disease.

2. Procedure

The procedure for CPT® Code 81511 involves several critical steps to ensure accurate measurement of the analytes in maternal serum:

• Step 1: Patient Preparation The patient is typically advised to schedule the blood draw during the optimal gestational window, which is between 14 weeks, 0 days and 24 weeks, 6 days. This timing is crucial for obtaining the most sensitive and accurate results.
• Step 2: Blood Sample Collection A blood sample is obtained through a venipuncture, which is a standard procedure where a needle is inserted into a vein to collect blood. This sample is essential for the subsequent biochemical analysis.
• Step 3: Serum Preparation After collection, the blood sample is processed to separate the serum from the cellular components. This serum is what will be tested for the analytes.
• Step 4: Analyte Testing The serum is then subjected to quantitative chemiluminescent immunoassay or electroluminescence assay techniques. These advanced testing methods allow for precise measurement of the four analytes: AFP, uE3, hCG, and DIA.
• Step 5: Risk Score Calculation Once the analytes are measured, the results are analyzed using an algorithm that calculates a risk score. This score indicates the likelihood of fetal congenital abnormalities and may include additional results from any previous biochemical testing.

3. Post-Procedure

After the procedure, the patient may be advised to follow up with their healthcare provider to discuss the results of the test. It is important to note that the interpretation of the risk score should be done in conjunction with other clinical findings and assessments. Patients may also be informed about the potential need for further testing or monitoring based on the results. There are generally no specific post-procedure care requirements, but patients should be aware of any signs of complications from the venipuncture, such as excessive bleeding or infection at the site.