CPT Code 83835 | Description & Clinical Information
CPT 83835 describes the laboratory procedure of quantifying the quantity of metanephrines, a metabolic byproduct of epinephrine, in a patient’s specimen, where elevated levels of metanephrines may indicate the presence of pheochromocytoma and adrenal tumors, which are often linked to hypertension.
Official Description
The CPT book defines CPT code 83835 as: “Metanephrines”.
Billing Guidelines
Refer to CPT codes 82382-82384 for catecholamines.
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Clinical Information
The procedure describes by CPT code 83835 is a metanephrine test that is used to detect the level of metanephrine in the body. Physicians order this test for patients with symptoms that suggest the presence of pheochromocytoma. These symptoms include recurring hypertension with headache, swelling, flushing, and rapid heart rate.
Metanephrine is a metabolic product of epinephrine that is excreted in the urine. In cases where adrenal tumors are present, the level of metanephrine excretion is also high. Typically, the lab analyst performs the test using a 24-hour urine collection as the patient specimen.
In performing the test, the lab analyst uses tandem mass spectrometry that employs multiple stages of separation and mass analysis. To begin the process, the analyst vaporizes the sample in the spectrometry instrument and ionizes the components with an electron beam. When exposed to electromagnetic fields, these ions separate according to their mass to charge ratio.
Finally, a detector detects these ions, which provides data for calculating the amount of specific components present in the sample. This process allows for the quantitation of the analyte, which refers to measuring the exact amount of a substance. Normal metanephrine levels in urine vary from lab to lab, but the amount of the analyte is usually reported per 24-hour period or per day.
It is important to note that the metanephrine test is not a diagnostic test for pheochromocytoma. Instead, it is a screening test that helps physicians determine whether further tests are necessary. If the results of the metanephrine test are positive, additional testing, such as imaging studies or a biopsy, may be ordered to confirm the presence of pheochromocytoma.
The accuracy of the metanephrine test is dependent on several factors, including proper collection and handling of the specimen, the instrument calibration, and the skill of the lab analyst. Additionally, certain medications and foods can interfere with the accuracy of the test results. Patients who are scheduled to undergo the metanephrine test should avoid consuming chocolate, coffee, tea, and vanilla for at least 24 hours before the test, as these substances can affect the accuracy of the results.
In conclusion, the metanephrine test is an important screening tool for patients with symptoms that suggest the presence of pheochromocytoma. When performed using tandem mass spectrometry, the test provides accurate and reliable results. However, it is important that patients follow the proper collection and specimen handling procedures and avoid consuming certain foods and medications before the test to ensure accurate results.
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