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December 2016 Texas Medicaid Provider Procedures Manual

Gynecological, Obstetrics, and Family Planning Title XIX Services Handbook : 4 Noninvasive Prenatal Testing (NIPT) : 4.1 Screening for Fetal Sex Chromosome Aneuploidy

4.1
In addition to trisomy (e.g., T13, T18, T21), NIPT procedure code 81420 may also screen for fetal SCA (e.g., 45, X; 47, XXX; 47, XXY; 47, XYY). It is recommended that diagnostic testing be offered rather than NIPT if a fetal structural anomaly (e.g., hydrops, cystic hygroma, cardiac malformations, abdominal wall defects, or skeletal abnormalities) is identified upon ultrasound examination.
Sex chromosome aneuploidy of maternal origin should be considered when NIPT results suggest fetal sex chromosome aneuploidy (e.g., 45, X; 47, XXX, 47, XXY; 47, XYY). Other considerations include the risk for incidental findings with NIPT. Appropriate client counseling is encouraged.

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