Pathology/Lab Coding Alert

Question: Our lab performs a non-invasive prenatal test for trisomy 18 and 21 called VisibiliT™ (by Sequenom, Inc.). The only similar CPT^® code I can find is 81507. Should I use 81507, or should I use the unlisted code 81599 to report the test?

Codify Subscriber

Answer: Neither code 81507 (Fetal aneuploidy (trisomy 21, 18, and 13) DNA sequence analysis of selected regions using maternal plasma, algorithm reported as a risk score for each trisomy) nor 81599 (Unlisted multianalyte assay with algorithmic analysis) is appropriate for the test you describe.

Do this: Bill the VisibiliT™ test using code 0009M (Fetal aneuploidy (trisomy 21, and 18) DNA sequence analysis of selected regions using maternal plasma, algorithm reported as a risk score for each trisomy).

Here’s why: Code 0009M is an Appendix O administrative code created specifically and only for the VisibiliT™ test. You should not use the unlisted Multianalyte Assays with Algorithmic Analysis (MAAA) code when a more specific code for the test exists.

Also note that code 81507 describes testing for trisomy 21, 18, and 13, while the test your lab performs evaluates only for trisomy 21 and 18 DNA sequence analysis.