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Official Description

Evaluation of cervicovaginal fluid for specific amniotic fluid protein(s) (eg, placental alpha microglobulin-1 [PAMG-1], placental protein 12 [PP12], alpha-fetoprotein), qualitative, each specimen

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The evaluation of cervicovaginal fluid for specific amniotic fluid proteins is a diagnostic procedure utilized primarily when there is a suspicion of premature rupture of membranes (PROM). This condition can lead to significant complications during pregnancy, making timely and accurate diagnosis crucial. The proteins assessed in this evaluation include placental alpha microglobulin-1 (PAMG-1), placental protein 12 (PP12), and alpha-fetoprotein (AFP). PAMG-1 is a protein that is produced in the fetal liver and yolk sac, and its concentration in amniotic fluid increases significantly during the second and third trimesters of pregnancy. PP12, on the other hand, is synthesized by the placental decidua and reaches its peak levels in the amniotic fluid during the first trimester, remaining elevated until delivery. AFP is another important protein that is initially produced by the yolk sac in early gestation and subsequently by the fetal liver and gastrointestinal tract. The testing process involves swabbing the cervix and vagina to collect cervicovaginal secretions, which are then analyzed using immunoassay techniques. These techniques employ a series of monoclonal and/or polyclonal antibodies to detect the presence of one or more of these specific proteins. The results of this evaluation can provide critical information regarding the integrity of the amniotic sac and help guide clinical decision-making in the management of the pregnancy.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The evaluation of cervicovaginal fluid for specific amniotic fluid proteins is indicated in the following situations:

  • Premature Rupture of Membranes (PROM) This procedure is performed when there is a clinical suspicion of PROM, which can lead to complications such as infection or preterm labor.

2. Procedure

The procedure for evaluating cervicovaginal fluid for specific amniotic fluid proteins involves several key steps:

  • Specimen Collection The first step in the procedure is the collection of cervicovaginal secretions. This is done by swabbing the cervix and vagina to obtain a sample that will be tested for the presence of specific proteins associated with amniotic fluid.
  • Testing Methodology Once the specimen is collected, it is subjected to testing using immunoassay techniques. This involves the use of monoclonal and/or polyclonal antibodies that are specifically designed to detect the target proteins, such as PAMG-1, PP12, and AFP.
  • Result Interpretation After the testing is completed, the results are analyzed to determine whether elevated levels of one or more of the specific proteins are present in the cervicovaginal fluid. The presence of these proteins may indicate that the amniotic sac has been compromised, suggesting a potential rupture.

3. Post-Procedure

Post-procedure care typically involves monitoring the patient for any signs of complications related to PROM, such as infection or labor. The healthcare provider may provide guidance on follow-up care and any necessary interventions based on the test results. It is essential to ensure that the patient is informed about the implications of the test results and any further steps that may be required in the management of their pregnancy.

Short Descr EVAL AMNIOTIC FLUID PROTEIN
Medium Descr EVAL C/V AMNIOTIC FLUID PROTEIN QUAL EA SPECIMEN
Long Descr Evaluation of cervicovaginal fluid for specific amniotic fluid protein(s) (eg, placental alpha microglobulin-1 [PAMG-1], placental protein 12 [PP12], alpha-fetoprotein), qualitative, each specimen
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 233 - Laboratory - Chemistry and Hematology
26 Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number.
90 Reference (outside) laboratory: when laboratory procedures are performed by a party other than the treating or reporting physician or other qualified health care professional, the procedure may be identified by adding modifier 90 to the usual procedure number.
Date
Action
Notes
2014-01-01 Changed Description Changed
2011-01-01 Added Added
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