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The procedure described by CPT® Code 89291 involves the biopsy of oocyte polar bodies or embryo blastomeres using microtechniques specifically for pre-implantation genetic diagnosis (PGD). This procedure is particularly relevant for patients who are known carriers of specific genetic diseases, as it allows for the identification of genetically normal oocytes or embryos prior to implantation. The process begins with a microscopic examination of the oocyte to assess its maturity if the biopsy is performed on an oocyte. In the case of an embryo, the viability of the embryo is also evaluated. During the procedure, the oocyte or embryo is carefully held in place with a holding pipette while being observed under a microscope. A small incision is made in the oocyte or embryo using either mechanical or enzymatic methods. Following this, a biopsy pipette is utilized to extract one or two polar bodies or blastomeres, which are then sent for genetic analysis. It is important to note that this code is applicable when the biopsy is performed on more than five oocytes or embryos, distinguishing it from CPT® Code 89290, which is used for the biopsy of five or fewer oocytes or embryos.
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The procedure coded as CPT® 89291 is indicated for patients who are known carriers of certain genetic diseases. The primary purpose of this biopsy is to identify genetically normal oocytes or embryos, which is crucial for couples undergoing in vitro fertilization (IVF) who wish to avoid passing on genetic disorders to their offspring. This procedure is particularly relevant in cases where there is a family history of genetic conditions, or when previous genetic testing has indicated a risk of hereditary diseases.
The procedure begins with the selection of oocytes or embryos for biopsy. If the biopsy is to be performed on oocytes, they are first examined microscopically to assess their maturity. This step is critical, as only mature oocytes are suitable for genetic testing. In cases where embryos are being biopsied, the viability of the embryos is evaluated to ensure that only healthy embryos are subjected to the biopsy process. Once the appropriate oocyte or embryo is identified, it is carefully grasped using a holding pipette, which stabilizes the specimen under microscopic observation. A small hole is then created in the oocyte or embryo using either a mechanical technique, such as a microneedle, or an enzymatic technique that facilitates the removal of cellular material. Following the creation of this opening, a biopsy pipette is employed to extract one or two polar bodies or blastomeres. These cellular components are then collected for separate genetic analysis, which will determine the genetic health of the oocyte or embryo.
After the biopsy procedure is completed, the extracted polar bodies or blastomeres are sent for genetic analysis to determine their genetic status. The results of this analysis will guide the selection of embryos for implantation during the IVF process. Patients may be monitored for any immediate post-procedure effects, although specific post-procedure care details are not explicitly mentioned. It is essential for healthcare providers to communicate the results of the genetic testing to the patients and discuss the implications for their reproductive options moving forward.
| Short Descr | BIOPSY OOCYTE POLAR BODY | Medium Descr | BX OOCYTE MICROTQ >5 EMBRY | Long Descr | Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); greater than 5 embryos | 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 | APC Status Indicator | STV-Packaged Codes | Type of Service (TOS) | 5 - Diagnostic Laboratory | Berenson-Eggers TOS (BETOS) | T1H - Lab tests - other (non-Medicare fee schedule) | MUE | 1 | CCS Clinical Classification | 206 - Microscopic examination (bacterial smear, culture, toxicology) |
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| 2013-01-01 | Changed | Medium Descriptor changed. |
| 2011-01-01 | Changed | Short description changed. |
| 2004-01-01 | Added | First appearance in code book in 2004. |
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