CPT® Code 88140

1. Indications

The procedure associated with CPT® Code 88140 is indicated for the identification of sex chromatin in cases where chromosomal sex determination is necessary. This may include the following conditions:

• Genetic Disorders Assessment of individuals with suspected genetic disorders that may be linked to chromosomal abnormalities.
• Sex Development Disorders Evaluation of individuals with ambiguous genitalia or disorders of sexual development.
• Infertility Investigations Investigation of infertility issues where chromosomal factors may play a role.
• Pre-natal Diagnosis Pre-natal testing to determine the sex of the fetus in certain clinical scenarios.

2. Procedure

The procedure for CPT® Code 88140 involves several key steps to ensure accurate identification of sex chromatin. First, a peripheral blood sample is obtained from the patient. This sample is crucial as it contains the leukocytes necessary for analysis. Next, the blood smear is prepared, which involves spreading a thin layer of the blood on a microscope slide to create a uniform sample for examination. Following this, an X-chromosome-specific nucleic acid probe is applied to the smear. This probe is designed to bind specifically to the X-chromosomes present in the leukocyte nuclei. After the probe has been applied, in situ hybridization is performed, allowing the probe to hybridize with the target X-chromosomes. Once hybridization is complete, the specimen is examined under a microscope for the presence of drumstick-like structures in the polymorphonuclear leukocytes. These structures are characteristic of females, as they indicate the presence of Barr bodies, which are inactivated X-chromosomes. The identification of these structures confirms the chromosomal sex of the individual being tested.

3. Post-Procedure

After the completion of the procedure associated with CPT® Code 88140, there are no specific post-procedure care requirements mentioned. However, it is essential for healthcare professionals to ensure that the results of the sex chromatin identification are accurately documented and communicated to the relevant parties. Patients may be advised to follow up with their healthcare provider to discuss the results and any further steps that may be necessary based on the findings. Additionally, proper handling and storage of the blood sample and smear are crucial to maintain the integrity of the results for future reference or additional testing if required.