Noninvasive Prenatal Testing for Fetal Aneuploidy: New Benefit

Effective retroactively for dates of service on or after May 1, 2013, noninvasive prenatal testing for fetal aneuploidy is reimbursable with CPT code 81479 (unlisted molecular pathology procedure). A Treatment Authorization Request (TAR) is required. A TAR for the test requires documentation of the following criteria:

• Patient with singleton gestation only.
• The patient has an increased risk of aneuploidy due to one or more of the following:
  • Maternal age 35 years or older at delivery
  • Fetal ultrasonographic findings indicating an increased risk of aneuploidy
  • History of a prior pregnancy with a trisomy
  • Positive test result for aneuploidy, including first trimester, sequential, or integrated screen, or a quadruple screen
  • Parental balanced Robertsonian translocation with increased risk of fetal trisomy 13 or trisomy 21

Source: General Medicine | June 2013 | Bulletin 468