CPT Code 0117U | Description & Clinical Information
CPT 0117U describes a unique lab test, the Foundation PI test from Ethos Laboratories, which utilizes LC-MS/MS to analyze a patient’s urine for metabolic compounds and metabolism breakdown products associated with chronic pain, and generates a pain index score based on an algorithm that incorporates the patient’s data and the values of biochemical markers related to pain.
Official Description
The CPT book defines CPT code 0117U as: “Pain management, analysis of 11 endogenous analytes (methylmalonic acid, xanthurenic acid, homocysteine, pyroglutamic acid, vanilmandelate, 5-hydroxyindoleacetic acid, hydroxymethylglutarate, ethylmalonate, 3-hydroxypropyl mercapturic acid (3-HPMA), quinolinic acid, kynurenic acid), LC-MS/MS, urine, algorithm reported as a pain-index score with likelihood of atypical biochemical function associated with pain”.
Clinical Information
The procedure described by CPT code 0117U is a complex, quantitative test performed on a urine sample to measure certain biomarkers indicative of chronic inflammation, neurotransmitter status, nerve health, and oxidative stress. This test is conducted by a lab analyst using an automated analytical instrument that separates components in the sample via high-pressure liquid chromatography and ionizes them before transferring them to mass spectrometers to provide structural identity and quantification of individual components based on mass to charge ratio.
This procedure measures the levels of several biomarkers, including methylmalonic acid, xanthurenic acid, homocysteine, pyroglutamic acid, vanilmandelate, 5-hydroxyindoleacetic acid, hydroxymethylglutarate, ethylmalonate, 3-hydroxypropyl mercapturic acid, and quinolinic and kynurenic acids. These substances are related to vitamin deficiencies, stress-related hormone breakdown, cholesterol synthesis, and biomarkers for certain types of neurological disorders.
An algorithmic analysis of these test results, along with certain patient data, provides a pain index score, which clinicians can use to correlate abnormal biomarker findings with non-opioid therapies. This can help maximize the chances of success for patients on prolonged pain management regimens.
The importance of this test lies in the fact that chronic inflammation, abnormal neurotransmitter function, certain vitamin deficiencies, and increased oxidative stress play key roles in the development and worsening of chronic pain. By accurately measuring these biomarkers and correlating them with non-opioid therapies tailored to the patient, clinicians can help patients manage their pain better and reduce the risk of opioid addiction.
In conclusion, the CPT 0117U procedure is a valuable tool in aiding clinicians to manage chronic pain patients more effectively. By accurately measuring and analyzing certain biomarkers, clinicians can tailor non-opioid therapy to combat inflammation, improve nerve health, and support healthy neurotransmitter function, thus helping to improve patient outcomes and quality of life.
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