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The CPT® Code 88274 refers to a laboratory test that focuses on molecular cytogenetics through the technique of interphase in situ hybridization. This procedure is essential for analyzing the genetic material of various biological samples, including bone marrow, blood, amniotic fluid, chorionic villi, and other tissues or tumors. Molecular cytogenetics is a field that examines the biology of chromosomes, encompassing their structure, functional organization, abnormalities, and variations within the genome. The interphase in situ hybridization method specifically targets the nuclei of eukaryotic cells, allowing for a detailed analysis of chromosomal characteristics. This technique employs interphase fluorescence in situ hybridization (I-FISH), which broadens the range of cell types that can be effectively analyzed. Samples for this test are typically obtained through various procedures, such as venipuncture, bone marrow aspiration, amniocentesis, chorionic villus sampling, and biopsy, which are reported separately. The analysis can provide rapid detection of chromosomal aneuploidy, particularly for chromosomes X, Y, 13, 18, and 21, in maternal amniotic fluid or chorionic villi, as well as in whole blood from infants. Additionally, the examination of bone marrow or whole blood is crucial for risk stratification in patients with newly diagnosed or relapsed multiple myeloma, detecting genomic abnormalities in chronic lymphocytic leukemia, and aiding in the diagnosis and classification of hematopoietic neoplasms presenting with eosinophilia. Furthermore, this procedure supports the diagnosis of acute lymphocytic leukemia and confirms the presence of PML-RARA translocation in acute promyelocytic leukemia. It is also utilized to exclude cryptic BCR-ABL1 rearrangements in myelogenous leukemia patients or PDGFRA abnormalities in those with neoplastic eosinophilia. The analysis of bone marrow or whole blood can help diagnose and predict aggressive morphologic features in cases of Burkitt lymphoma versus diffuse large B-cell lymphoma, as well as monitor minimal residual disease in therapy-related myelodysplastic syndrome (MDS) or acute myelogenous leukemia associated with MDS. Lastly, whole blood samples may be examined to identify significant translocations in patients newly diagnosed with acute myeloid leukemia. The specific code 88274 is applied when the analysis involves studying 25 to 99 cells, while code 88275 is designated for studies involving 100 to 300 cells.
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The procedure associated with CPT® Code 88274 is indicated for various clinical scenarios where molecular cytogenetic analysis is necessary. The following conditions and situations warrant the use of this test:
The procedure for CPT® Code 88274 involves several critical steps to ensure accurate molecular cytogenetic analysis. The following outlines the procedural steps:
After the procedure associated with CPT® Code 88274, the following post-procedure considerations are important:
Patients may not require specific post-procedure care related to the molecular cytogenetic analysis itself, as the procedure primarily involves laboratory testing rather than direct patient intervention. However, it is essential for healthcare providers to communicate the results of the analysis to the patient and discuss any necessary follow-up actions based on the findings. This may include further diagnostic testing, treatment planning, or referrals to specialists depending on the identified chromosomal abnormalities and their clinical significance. Additionally, healthcare providers should ensure that the documentation of the procedure and results is complete and accurate for billing and compliance purposes.
| Short Descr | CYTOGENETICS 25-99 | Medium Descr | MOLECULAR CYTOGENETICS INTERPHASE ISH 25-99 CLL | Long Descr | Molecular cytogenetics; interphase in situ hybridization, analyze 25-99 cells | 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 | 5 | CCS Clinical Classification | 235 - Other Laboratory |
| 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. | 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. | 91 | Repeat clinical diagnostic laboratory test: in the course of treatment of the patient, it may be necessary to repeat the same laboratory test on the same day to obtain subsequent (multiple) test results. under these circumstances, the laboratory test performed can be identified by its usual procedure number and the addition of modifier 91. note: this modifier may not be used when tests are rerun to confirm initial results; due to testing problems with specimens or equipment; or for any other reason when a normal, one-time, reportable result is all that is required. this modifier may not be used when other code(s) describe a series of test results (eg, glucose tolerance tests, evocative/suppression testing). this modifier may only be used for laboratory test(s) performed more than once on the same day on the same patient. | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | GZ | Item or service expected to be denied as not reasonable and necessary | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2011-01-01 | Changed | Short description changed. |
| 1999-01-01 | Added | First appearance in code book in 1999. |
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