Need help choosing the right code?
Ask CasePilot about procedures, modifiers, bundling, and coding guidance.
Try CasePilot© Copyright 2026 American Medical Association. All rights reserved.
The CPT® Code 81507 pertains to the non-invasive detection of fetal aneuploidy, specifically targeting trisomies 21, 18, and 13. This procedure involves the analysis of fetal DNA that is shed from the placenta and circulates within the maternal plasma. By utilizing advanced sequencing techniques, such as shotgun sequencing, multiplex ligation-dependent probe amplification (MLPA), and digital polymerase chain reaction (digital PCR), healthcare professionals can assess the risk of these chromosomal abnormalities. The algorithm generated from this analysis provides a risk score for each trisomy, offering a more accurate assessment compared to traditional methods that rely on maternal age and biochemical markers, including human chorionic gonadotropin (hCG), unconjugated estriol, alpha-fetoprotein, inhibin A, or pregnancy-associated plasma protein A (PAPP-A). While these conventional tests are often conducted initially, the results may lead to subsequent DNA sequencing for a more definitive risk evaluation. The implementation of non-invasive screening significantly reduces the necessity for more invasive diagnostic procedures, such as chorionic villus sampling and amniocentesis, which carry higher risks for both maternal and fetal complications.
© Copyright 2026 Coding Ahead. All rights reserved.
The procedure associated with CPT® Code 81507 is indicated for the non-invasive assessment of fetal aneuploidy, specifically for the following conditions:
The procedure for CPT® Code 81507 involves several key steps to ensure accurate analysis of fetal DNA. First, a blood sample is collected from the pregnant individual, which contains maternal plasma. This plasma is then processed to isolate the fetal DNA that has been shed from the placenta. Following isolation, advanced sequencing techniques are employed to analyze the selected regions of the fetal DNA. Techniques such as shotgun sequencing, multiplex ligation-dependent probe amplification (MLPA), or digital polymerase chain reaction (digital PCR) may be utilized to perform the analysis. The results of this sequencing are then interpreted using an algorithm that calculates a risk score for each of the trisomies being assessed. This risk score provides a quantitative measure of the likelihood that the fetus may be affected by trisomy 21, 18, or 13, allowing healthcare providers to make informed decisions regarding further testing or monitoring.
After the completion of the fetal aneuploidy DNA sequence analysis, the results are typically communicated to the healthcare provider who ordered the test. The risk scores generated from the analysis can guide further clinical decision-making. If the risk scores indicate a higher likelihood of aneuploidy, the healthcare provider may discuss the option of more invasive diagnostic procedures, such as chorionic villus sampling or amniocentesis, which can provide definitive results. Additionally, the individual may be counseled regarding the implications of the results, including potential follow-up care and support resources. It is important to note that the non-invasive nature of this screening reduces the risk of complications associated with invasive procedures, making it a safer option for assessing fetal health.
| Short Descr | FETAL ANEUPLOIDY TRISOM RISK | Medium Descr | FETAL ANEUPLOIDY 21 18 13 SEQ ANALY TRISOM RISK | Long Descr | 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 | 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 | 1 |
| 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. |
|
Date
|
Action
|
Notes
|
|---|---|---|
| 2017-01-01 | Changed | Guideline added. |
| 2014-01-01 | Added | Added |
Get instant expert-level medical coding assistance.