How To Use CPT Code 0014M

CPT 0014M describes the analysis of three biomarkers for liver disease using immunoassays. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 0014M?

CPT 0014M can be used to analyze three biomarkers (hyaluronic acid [HA], procollagen III amino terminal peptide [PIIINP], tissue inhibitor of metalloproteinase 1 [TIMP-1]) for liver disease using immunoassays. The test also utilizes a prognostic algorithm to report a risk score and the risk of liver fibrosis and liver-related clinical events within 5 years.

2. Official Description

The official description of CPT code 0014M is: ‘Liver disease, analysis of 3 biomarkers (hyaluronic acid [HA], procollagen III amino terminal peptide [PIIINP], tissue inhibitor of metalloproteinase 1 [TIMP-1]), using immunoassays, utilizing serum, prognostic algorithm reported as a risk score and risk of liver fibrosis and liver-related clinical events within 5 years.’

3. Procedure

1. The lab analyst performs immunoassays on a patient’s serum sample for three biomarkers: hyaluronic acid (HA), procollagen III amino terminal peptide (PIIINP), and tissue inhibitor of metalloproteinase 1 (TIMP-1).
2. The lab analyst inputs the test results and patient data into a computer program.
3. The computer program analyzes the data using a specific algorithm to calculate a risk score for liver fibrosis.
4. The risk score indicates the likelihood of liver-related clinical events occurring within 5 years.

4. Qualifying circumstances

This test is ordered by clinicians to assess liver status in patients at risk for chronic liver disease. It is not limited to testing for a specific condition. The biomarkers analyzed in CPT 0014M are indicators of liver fibrosis, and increased levels of these biomarkers suggest tissue damage and scarring. The test is used for screening and follow-up of patients with liver disease.

5. When to use CPT code 0014M

CPT code 0014M should be used when analyzing the three biomarkers (HA, PIIINP, TIMP-1) for liver disease using immunoassays. This code is appropriate for assessing liver fibrosis and predicting the risk of liver-related clinical events within 5 years.

6. Documentation requirements

To support a claim for CPT code 0014M, the following documentation is required:

• Patient data and test results for the three biomarkers (HA, PIIINP, TIMP-1)
• Specific algorithm used for the analysis
• Risk score for liver fibrosis
• Explanation of the risk of liver-related clinical events within 5 years

7. Billing guidelines

When billing for CPT code 0014M, ensure that the analysis of the three biomarkers (HA, PIIINP, TIMP-1) using immunoassays is performed. This code should not be reported with other codes related to liver disease analysis. It is important to follow the specific guidelines provided by the payer and include any necessary modifiers for accurate billing.

8. Historical information

CPT code 0014M was added to the Current Procedural Terminology system on April 1, 2020. There have been no updates to the code since its addition.

9. Examples

1. A patient at risk for chronic liver disease undergoes an analysis of three biomarkers (HA, PIIINP, TIMP-1) using immunoassays. The test results indicate a high risk of liver fibrosis and liver-related clinical events within 5 years.
2. A clinician orders CPT code 0014M for a patient with suspected liver disease. The analysis of the three biomarkers helps assess the severity of liver fibrosis and predicts the risk of future liver-related clinical events.
3. A patient with a history of liver disease undergoes regular monitoring using CPT code 0014M. The test results provide valuable information about the progression of liver fibrosis and the likelihood of liver-related clinical events occurring within 5 years.
4. A healthcare provider uses CPT code 0014M to analyze the three biomarkers in a patient with suspected liver fibrosis. The test results confirm the presence of liver disease and provide a risk score for future liver-related clinical events.
5. A patient with a family history of liver disease undergoes an analysis of the three biomarkers using CPT code 0014M. The test results indicate a low risk of liver fibrosis and liver-related clinical events within 5 years.
6. A clinician orders CPT code 0014M for a patient with elevated liver enzymes. The analysis of the three biomarkers helps determine the underlying cause of liver dysfunction and assess the risk of liver fibrosis and future clinical events.
7. A patient with a history of alcohol abuse undergoes regular monitoring using CPT code 0014M. The test results provide important information about the progression of liver fibrosis and the risk of liver-related clinical events within 5 years.
8. A healthcare provider uses CPT code 0014M to assess the liver status of a patient with a known liver disease. The analysis of the three biomarkers helps monitor the progression of liver fibrosis and predict the risk of future liver-related clinical events.
9. A patient with a liver transplant undergoes an analysis of the three biomarkers using CPT code 0014M. The test results provide valuable information about the health of the transplanted liver and the risk of liver-related clinical events within 5 years.
10. A clinician orders CPT code 0014M for a patient with suspected liver fibrosis. The analysis of the three biomarkers helps confirm the diagnosis and assess the severity of liver disease.