How To Use CPT Code 83520

CPT 83520 is an immunoassay code used for the quantitative measurement of non-infectious analytes. This article will cover the description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT code 83520 procedures.

1. What is CPT 83520?

CPT 83520 is a code used in medical billing and coding for a specific type of laboratory test called an immunoassay. This test measures the concentration of an analyte, which is not an infectious agent antibody or infectious agent antigen, in a quantitative manner. The code is used when there is no specific code assigned for the analyte being tested, but the test meets the requirements of CPT 83520 based on the methodology and the analyte being tested.

2. 83520 CPT code description

The official description of CPT code 83520 is: “Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, not otherwise specified.”

3. Procedure

The 83520 procedure involves the following steps:

1. Collection of the specimen from the patient.
2. Preparation of the specimen for analysis, which may include centrifugation, filtration, or other methods to separate the analyte from other components in the sample.
3. Performing the immunoassay, which involves the use of antibodies or antigens to detect the presence and concentration of the analyte in the sample.
4. Quantitative measurement of the analyte using specialized equipment and techniques, such as spectrophotometry or enzyme-linked immunosorbent assay (ELISA).
5. Interpretation of the results and reporting the findings to the healthcare provider.

4. Qualifying circumstances

Patients who are eligible to receive CPT code 83520 services are those who require the quantitative measurement of a non-infectious analyte for diagnostic or monitoring purposes. This may include patients with suspected or confirmed medical conditions that involve abnormal levels of specific analytes, such as hormones, proteins, or other substances. Additionally, patients undergoing certain treatments or therapies may require regular monitoring of analyte levels to ensure the effectiveness and safety of the treatment.

5. When to use CPT code 83520

It is appropriate to bill the 83520 CPT code when a healthcare provider orders a quantitative immunoassay for an analyte other than infectious agent antibody or infectious agent antigen, and there is no specific code assigned for the analyte being tested. The test must meet the requirements of CPT 83520 based on the methodology and the analyte being tested.

6. Documentation requirements

To support a claim for CPT 83520, the following information should be documented:

• The patient’s medical history and relevant clinical findings.
• The healthcare provider’s order for the immunoassay, including the specific analyte to be measured and the reason for the test.
• A detailed description of the procedure, including the steps taken to prepare the specimen, perform the immunoassay, and measure the analyte.
• The results of the test, including the quantitative measurement of the analyte and any relevant reference ranges or clinical guidelines.
• Interpretation of the results and any recommendations for further testing or treatment, if applicable.

7. Billing guidelines

When billing for CPT code 83520, it is important to follow the appropriate guidelines and rules to ensure accurate reimbursement. Some tips and codes that apply to CPT code 83520 include:

• Ensure that the test meets the requirements of CPT 83520 based on the methodology and the analyte being tested.
• Document the necessary information to support the claim, as outlined in the documentation requirements section.
• Use the appropriate modifiers, if necessary, to indicate any special circumstances related to the test, such as repeat testing or multiple analytes.
• Review payer-specific guidelines and policies for any additional requirements or restrictions related to CPT code 83520.

8. Historical information

CPT 83520 was added to the Current Procedural Terminology system on January 1, 1993. The code was changed on January 1, 2010, with the previous descriptor being “Immunoassay, analyte, quantitative; not otherwise specified.”

9. Similar codes to CPT 83520

Five similar codes to CPT 83520 and how they differentiate from CPT 83520 are:

1. CPT 86316: This code is used for immunoassay of tumor antigen not elsewhere specified, rather than non-infectious analytes.
2. CPT 82784: This code is used for the measurement of immunoglobulins, which are a specific type of protein, rather than non-infectious analytes.
3. CPT 82785: This code is also used for the measurement of immunoglobulins, but specifically for multiple allergen simultaneous tests (MAST).
4. CPT 83516: This code is used for immunoassays that are qualitative or semiquantitative, rather than quantitative.
5. CPT 83519: This code is used for immunoassays that are quantitative and involve infectious agent antibodies or infectious agent antigens, rather than non-infectious analytes.

10. Examples

Here are 10 detailed examples of CPT code 83520 procedures:

1. Quantitative measurement of a hormone, such as insulin, in a patient with suspected diabetes.
2. Quantitative measurement of a protein, such as C-reactive protein, in a patient with suspected inflammation or infection.
3. Quantitative measurement of a drug, such as digoxin, in a patient undergoing treatment for heart failure.
4. Quantitative measurement of a vitamin, such as vitamin D, in a patient with suspected deficiency.
5. Quantitative measurement of a biomarker, such as prostate-specific antigen (PSA), in a patient with suspected prostate cancer.
6. Quantitative measurement of a neurotransmitter, such as serotonin, in a patient with suspected depression.
7. Quantitative measurement of an enzyme, such as lactate dehydrogenase (LDH), in a patient with suspected tissue damage.
8. Quantitative measurement of a metabolic product, such as ammonia, in a patient with suspected liver disease.
9. Quantitative measurement of a growth factor, such as erythropoietin, in a patient with suspected anemia.
10. Quantitative measurement of a coagulation factor, such as factor VIII, in a patient with suspected hemophilia.