How To Use CPT Code 83550

CPT 83550 is a code used for measuring iron binding capacity in a serum sample, which is essential for evaluating various medical conditions. This article will cover the description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT code 83550.

1. What is CPT 83550?

CPT 83550 is a code used to represent the laboratory procedure of measuring the iron binding capacity in a serum sample. This test is crucial for evaluating anemia, neoplasms, liver disease, iron poisoning, and many other conditions. The iron binding capacity is an important measurement of the capacity of iron to bind to transferrin, also known as transferrin saturation.

2. 83550 CPT code description

The official description of CPT code 83550 is: “Iron binding capacity.”

3. Procedure

The procedure for CPT 83550 involves the following steps:

1. Collection of a serum sample from the patient, typically through venipuncture.
2. Preparation of the serum sample for analysis.
3. Measurement of the iron binding capacity using spectrophotometry, which accurately measures the amount of light absorbed by the sample at a specific wavelength after a chemical reaction.
4. Quantitation of the analyte, which represents the iron binding capacity or transferrin saturation.
5. Interpretation of the results by a qualified professional.

4. Qualifying circumstances

Patients who are eligible to receive CPT code 83550 services are those who require evaluation for conditions such as anemia, neoplasms, liver disease, iron poisoning, and other related conditions. Clinicians may order this test as total iron binding capacity or as TIBC. Some payers may pay separately for collecting the specimen using a code such as 36415, Collection of venous blood by venipuncture.

5. When to use CPT code 83550

It is appropriate to bill the 83550 CPT code when a clinician orders the test to evaluate a patient’s iron binding capacity for the diagnosis or monitoring of conditions such as anemia, neoplasms, liver disease, iron poisoning, and other related conditions. The test results can provide valuable information to guide treatment decisions and monitor the patient’s response to therapy.

6. Documentation requirements

To support a claim for CPT 83550, the following information needs to be documented:

• Patient’s demographic information, including name, date of birth, and medical record number.
• Relevant clinical history and physical examination findings.
• Indication for the test, such as suspected anemia, liver disease, or iron poisoning.
• Order for the test, including the specific test requested (iron binding capacity or TIBC).
• Date and time of the specimen collection.
• Results of the test, including the iron binding capacity or transferrin saturation value.
• Interpretation of the results by a qualified professional.
• Any relevant follow-up or treatment recommendations based on the test results.

7. Billing guidelines

When billing for CPT code 83550, it is essential to follow the specific guidelines and rules set by the payer. Some payers may require prior authorization for the test or may only cover the test under certain circumstances. Additionally, some payers may pay separately for the specimen collection using a code such as 36415, Collection of venous blood by venipuncture. It is crucial to verify the payer’s requirements and ensure that all necessary documentation is provided to support the claim.

8. Historical information

CPT 83550 was added to the Current Procedural Terminology system on January 1, 1990. There have been no significant updates to the code since its addition.

9. Similar codes to CPT 83550

Five similar codes to CPT 83550 and how they differentiate from CPT 83550 are:

• CPT 83540: This code is used for measuring the iron level in a serum sample, which is often ordered alongside CPT 83550 to evaluate iron status.
• CPT 83590: This code is used for measuring the unsaturated iron binding capacity, which is another component of iron status evaluation.
• CPT 84466: This code is used for measuring transferrin, a protein that transports iron in the blood and is related to iron binding capacity.
• CPT 82728: This code is used for measuring ferritin, a protein that stores iron in the body and is another marker of iron status.
• CPT 85014: This code is used for measuring hematocrit, which is the percentage of red blood cells in the blood and can be affected by iron status.

10. Examples

Here are 10 detailed examples of CPT code 83550 procedures:

1. A patient with a history of anemia presents with fatigue and pallor. The clinician orders an iron binding capacity test to evaluate the patient’s iron status and guide treatment decisions.
2. A patient with a known liver disease requires monitoring of their iron binding capacity to assess the progression of the disease and the effectiveness of treatment.
3. A patient with a suspected iron poisoning presents with abdominal pain, vomiting, and diarrhea. The clinician orders an iron binding capacity test to confirm the diagnosis and determine the severity of the poisoning.
4. A patient with a history of neoplasms requires an iron binding capacity test to evaluate their iron status and the potential impact on their overall health.
5. A patient with a family history of hemochromatosis, a genetic disorder that causes excessive iron absorption, undergoes an iron binding capacity test to determine their risk of developing the condition.
6. A patient with chronic kidney disease requires an iron binding capacity test to assess their iron status and the need for iron supplementation or other treatments.
7. A patient with a history of gastrointestinal bleeding undergoes an iron binding capacity test to evaluate their iron status and the potential need for iron supplementation or other treatments.
8. A patient with a history of heavy menstrual bleeding requires an iron binding capacity test to assess their iron status and the potential need for iron supplementation or other treatments.
9. A patient with a history of malabsorption syndromes, such as celiac disease or inflammatory bowel disease, undergoes an iron binding capacity test to evaluate their iron status and the potential need for iron supplementation or other treatments.
10. A patient with a history of bariatric surgery requires an iron binding capacity test to assess their iron status and the potential need for iron supplementation or other treatments.