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chromosome analysis

Victoria Posted Fri 28th of June, 2019 17:59:44 PM
Hello I am needing some help understanding the difference between 88262 and 88230? Is it appropriate to 88262,88230,88291 together? And is 88230 considered an add on code for 88262? And do you always have to report 88291, even if it is not necessary?
SuperCoder Answered Mon 01st of July, 2019 10:26:36 AM


There are no NCCI edits for code 88262, 88230 and 88291.

To understand the difference between the two codes, kindly go through with the details given below for each code.

Code 88262 (Chromosome analysis; count 15-20 cells, 2 karyotypes, with banding)

The analyst performs a chromosome analysis, a test that examines a person’s genetic material for abnormalities, counts 15 to 20 cells, and makes two karyotypes with banding, which are pictures of the actual chromosomes.

The analyst performs a chromosome analysis, using a sample such as whole blood, bone marrow, or tissue culture. He places actively dividing cells that have observable chromosomes on slides and applies special stains that reveal the chromosomes. Depending on the type of stain used, alternating light and dark patterns form, called banding, that identify the individual chromosomes. The analyst counts 15 to 20 cells, arranges the chromosomes from one to 23, and produces two images of the number and appearance of the cell’s chromosomes, called a karyotype. Karyotypes help to visualize and evaluate normal and abnormal chromosomal characteristics. Abnormalities of the number of chromosomes typically occur in all cells of an individual, therefore, two karyotypes adequately reveal any abnormalities of chromosome number.

Although not limited to testing for a specific condition, providers typically order a chromosome analysis to diagnose genetic abnormalities, such as Down syndrome, caused by an extra chromosome 21, or Edwards syndrome, an extra chromosome 18.


Code 88230 (Tissue culture for non-neoplastic disorders; lymphocyte)

The lab analyst performs a procedure to grow a tissue culture for lymphocytes in a nonneoplastic disorder, typically using blood. Lymphocytes, a type of white blood cell, function as part of the immune system and produce antibodies.

The lab analyst performs the technical steps on the patient’s sample to culture, or increase the numbers of, lymphocytes. He transfers blood to a flask containing a mixture of substances that cause the cells to reproduce and incubates the flask for about three to four days at 37 degrees C. As the cells multiply, the DNA containing structures called chromosomes in the nucleus pass through a stage of division called metaphase during which the chromosomes become clearly visible and ready for further testing, such as flow cytometry.

Although not limited to testing for specific conditions, clinicians may order this test to increase and process lymphocytes for testing in nonneoplastic conditions such as Turner syndrome, a female congenital disorder characterized by structural abnormalities caused by a missing chromosome.

88230 is not an add on code.

88291 needs to reported when abnormal cytogenetic tests require complex interpretations and the code is used to report physician interpretation and report of complex cytogenetic and molecular cytogenetic tests.

Hope this helps.


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