How To Use CPT Code 85730

CPT 85730 is a code used for measuring partial thromboplastin time (PTT) in plasma or whole blood, which helps diagnose bleeding disorders and monitor anticoagulant therapy. This article will cover the description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 85730 procedures.

1. What is CPT 85730?

CPT 85730 is a code used in the medical field to represent a specific laboratory test that measures the partial thromboplastin time (PTT) in plasma or whole blood. This test is essential for diagnosing bleeding disorders and monitoring anticoagulant therapy in patients. Medical professionals use this code to bill for the services provided during the PTT test.

2. 85730 CPT code description

The official description of CPT code 85730 is: “Thromboplastin time, partial (PTT); plasma or whole blood.”

3. Procedure

The 85730 procedure involves the following steps:

1. Collection of a blood sample from the patient.
2. Separation of plasma from the blood sample, if necessary.
3. Preparation of the sample by mixing it with reagents.
4. Analysis of the sample using a laboratory coagulation instrument that measures clot detection by nephelometry or a portable device for whole blood testing.
5. Monitoring the time, in seconds, required for the plasma or whole blood to clot.
6. Interpretation of the results to diagnose bleeding disorders or monitor anticoagulant therapy.

4. Qualifying circumstances

Patients eligible to receive CPT code 85730 services include those who:

• Have a history of bleeding disorders or are suspected of having a bleeding disorder.
• Are receiving heparin therapy for thrombosis treatment.
• Require monitoring of their anticoagulant therapy.
• Have a suspected presence of lupus anticoagulants or other autoantibodies that interfere with the body’s coagulation mechanism.

5. When to use CPT code 85730

It is appropriate to bill the 85730 CPT code when a medical professional performs a PTT test to diagnose bleeding disorders or monitor anticoagulant therapy in a patient. This code should be used for both plasma and whole blood testing methods.

6. Documentation requirements

To support a claim for CPT 85730, the following information needs to be documented:

• Patient’s medical history and reason for the PTT test.
• Details of the blood sample collection, including date and time.
• Method used for the PTT test (plasma or whole blood).
• Results of the PTT test, including the time in seconds for clot formation.
• Interpretation of the results and their relevance to the patient’s condition.
• Any follow-up actions or recommendations based on the test results.

7. Billing guidelines

When billing for CPT code 85730, medical professionals should adhere to the following guidelines:

• Ensure that the PTT test is medically necessary for the patient’s condition and treatment plan.
• Document all required information to support the claim, as mentioned in the documentation requirements section.
• Verify that the patient meets the qualifying circumstances for receiving CPT code 85730 services.
• Bill the 85730 CPT code only for the PTT test and not for any other related services or procedures.

8. Historical information

CPT 85730 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Similar codes to CPT 85730

Five similar codes to CPT 85730 and how they differentiate are:

• CPT 85610: This code is used for prothrombin time (PT) testing, which measures the time it takes for blood to clot and is used to monitor warfarin therapy.
• CPT 85732: This code is for thromboplastin time, partial, with kaolin, which is a variation of the PTT test that uses kaolin as an activator.
• CPT 85670: This code is for the thrombin time test, which measures the time it takes for fibrinogen to be converted to fibrin, a crucial step in the clotting process.
• CPT 85651: This code is for the sedimentation rate test, which measures the rate at which red blood cells settle in a test tube and can indicate inflammation in the body.
• CPT 85652: This code is for the red blood cell (RBC) count, which measures the number of red blood cells in a blood sample and can help diagnose anemia and other blood disorders.

10. Examples

Here are 10 detailed examples of CPT code 85730 procedures:

1. A patient with a history of unexplained bleeding episodes undergoes a PTT test to diagnose a potential bleeding disorder.
2. A patient receiving heparin therapy for deep vein thrombosis has a PTT test to monitor the effectiveness of the treatment.
3. A patient with a suspected lupus anticoagulant undergoes a PTT test to confirm the presence of the autoantibody.
4. A patient with a family history of hemophilia has a PTT test as part of a comprehensive coagulation screening.
5. A patient on long-term anticoagulant therapy has a PTT test to ensure their clotting time remains within the therapeutic range.
6. A patient with a history of recurrent miscarriages undergoes a PTT test to investigate potential clotting disorders.
7. A patient with liver disease has a PTT test to assess their clotting function and risk of bleeding complications.
8. A patient undergoing major surgery has a preoperative PTT test to evaluate their risk of excessive bleeding during the procedure.
9. A patient with a suspected von Willebrand disease undergoes a PTT test as part of the diagnostic process.
10. A patient with an autoimmune disorder has a PTT test to monitor the impact of their condition on their clotting function.