How To Use CPT Code 0002M

CPT 0002M describes a laboratory test that assesses liver disease using ten biochemical assays and a prognostic algorithm. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 0002M?

CPT 0002M is a laboratory test that evaluates liver disease by measuring ten different biochemical markers in the blood. These markers include ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, haptoglobin, AST, glucose, total cholesterol, and triglycerides. The test utilizes a prognostic algorithm to analyze the patient’s data and generate quantitative scores for fibrosis, steatosis (fatty liver), and alcoholic steatohepatitis (ASH).

2. Official Description

The official description of CPT code 0002M is: ‘Liver disease, ten biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, haptoglobin, AST, glucose, total cholesterol, and triglycerides) utilizing serum, prognostic algorithm reported as quantitative scores for fibrosis, steatosis, and alcoholic steatohepatitis (ASH).’

3. Procedure

1. The lab analyst performs ten biochemical assays on a blood sample, measuring the levels of ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, haptoglobin, AST, glucose, total cholesterol, and triglycerides.
2. The lab analyst inputs the test results into a computer program that utilizes a prognostic algorithm.
3. The algorithm analyzes the patient’s data, including the lab test results, to generate quantitative scores for liver fibrosis, steatosis, and alcoholic steatohepatitis (ASH).
4. The lab analyst reports the quantitative scores to the healthcare provider for further interpretation and diagnosis.

4. Qualifying circumstances

CPT 0002M is typically ordered for patients who have been diagnosed with liver disease and require an assessment of their liver status. It is commonly used in cases of alcoholic liver disease. The test is performed by a laboratory analyst who specializes in conducting biochemical assays and utilizing prognostic algorithms. The patient’s blood sample is used to measure the levels of specific markers, and the algorithm analyzes this data to provide quantitative scores for fibrosis, steatosis, and alcoholic steatohepatitis (ASH).

5. When to use CPT code 0002M

CPT code 0002M should be used when a healthcare provider orders a laboratory test to assess liver disease using the ten specified biochemical assays and a prognostic algorithm. It is important to ensure that the patient meets the qualifying circumstances for this test, such as having a confirmed diagnosis of liver disease and requiring an evaluation of their liver status. This code should be used for each instance of performing the test.

6. Documentation requirements

To support a claim for CPT code 0002M, the healthcare provider must document the following information:

• The patient’s diagnosis of liver disease
• The specific biochemical assays performed, including ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, haptoglobin, AST, glucose, total cholesterol, and triglycerides
• The date of the test
• The quantitative scores generated by the prognostic algorithm for fibrosis, steatosis, and alcoholic steatohepatitis (ASH)

7. Billing guidelines

When billing for CPT code 0002M, ensure that the test is performed by a qualified laboratory analyst and that the necessary biochemical assays and algorithmic analysis are conducted. It is important to follow any specific guidelines provided by the payer regarding the reporting of this code. Additionally, be aware that some payers may separately reimburse for the collection of the blood specimen using a separate code, such as 36415.

8. Historical information

CPT code 0002M was added to the Current Procedural Terminology system on January 1, 2013. There have been no updates to the code since its addition.

9. Examples

1. A healthcare provider orders CPT code 0002M for a patient with a confirmed diagnosis of alcoholic liver disease to assess their liver fibrosis, steatosis, and alcoholic steatohepatitis (ASH) scores.
2. A patient with suspected liver disease undergoes CPT code 0002M to evaluate their liver status and determine the severity of fibrosis, steatosis, and alcoholic steatohepatitis (ASH).
3. A healthcare provider utilizes CPT code 0002M to monitor the progression of liver disease in a patient and assess the effectiveness of their treatment plan.
4. A patient with a history of liver disease undergoes CPT code 0002M as part of their routine follow-up to ensure early detection of any worsening fibrosis, steatosis, or alcoholic steatohepatitis (ASH).
5. A healthcare provider orders CPT code 0002M for a patient with suspected liver fibrosis, steatosis, or alcoholic steatohepatitis (ASH) to confirm the diagnosis and guide further treatment decisions.
6. A patient with a family history of liver disease undergoes CPT code 0002M as a preventive measure to assess their liver health and identify any early signs of fibrosis, steatosis, or alcoholic steatohepatitis (ASH).
7. A healthcare provider utilizes CPT code 0002M to evaluate the liver status of a patient before and after a liver transplantation procedure.
8. A patient with a history of alcohol abuse undergoes CPT code 0002M to assess the impact of their drinking on their liver health and identify any fibrosis, steatosis, or alcoholic steatohepatitis (ASH).
9. A healthcare provider orders CPT code 0002M for a patient with suspected liver disease to determine the underlying cause and severity of fibrosis, steatosis, or alcoholic steatohepatitis (ASH).
10. A patient with a known liver disease undergoes CPT code 0002M to monitor the progression of their condition and assess the effectiveness of their current treatment plan.