How To Use CPT Code 0015M

CPT 0015M describes the biochemical assay of 25 steroid markers in a 24-hour urine specimen, along with clinical parameters, to determine the risk of adrenal cortical carcinoma, adenoma, or other adrenal malignancy. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 0015M?

CPT 0015M can be used to report the biochemical assay of 25 steroid markers in a 24-hour urine specimen, along with clinical parameters, to assess the risk of adrenal cortical carcinoma, adenoma, or other adrenal malignancy. This code is used when the lab analyst performs the technical lab steps to evaluate the urine sample and carries out an algorithmic analysis using patient data and the lab test results to report a risk score for these adrenal gland diseases.

2. Official Description

The official description of CPT code 0015M is: ‘Adrenal cortical tumor, biochemical assay of 25 steroid markers, utilizing 24-hour urine specimen and clinical parameters, prognostic algorithm reported as a clinical risk and integrated clinical steroid risk for adrenal cortical carcinoma, adenoma, or other adrenal malignancy.’

3. Procedure

1. The lab analyst performs a biochemical assay on a 24-hour urine sample to evaluate 25 steroid markers related to adrenal cortical tumors.
2. The lab analyst inputs the test results and patient data into a computer program for algorithmic analysis.
3. The algorithmic analysis considers the patient’s age at diagnosis, gender, how the mass was discovered, and tumor size and density.
4. The analysis produces a risk score that indicates the probability of adrenal cortical carcinoma or other adrenal malignancy.

4. Qualifying circumstances

Patients who may benefit from CPT 0015M are those with suspected adrenal cortical carcinoma, adenoma, or other adrenal malignancy. The test helps in diagnosing and providing prognostic assistance for these conditions. It is typically ordered by clinicians to assess the risk and guide treatment decisions. The lab analyst performs the assay and algorithmic analysis to determine the risk score based on the patient’s urine sample and clinical parameters.

5. When to use CPT code 0015M

CPT code 0015M should be used when a biochemical assay of 25 steroid markers in a 24-hour urine specimen, along with clinical parameters, is performed to evaluate the risk of adrenal cortical carcinoma, adenoma, or other adrenal malignancy. It is appropriate when the lab analysis and algorithmic analysis are carried out to provide a risk score for these conditions.

6. Documentation requirements

To support a claim for CPT 0015M, the documentation should include:

• Patient’s clinical information, including age at diagnosis, gender, how the mass was discovered, and tumor size and density
• Results of the biochemical assay of 25 steroid markers in the 24-hour urine specimen
• Details of the algorithmic analysis and the risk score reported

7. Billing guidelines

When billing for CPT 0015M, ensure that the biochemical assay of 25 steroid markers in the 24-hour urine specimen, along with clinical parameters, is performed. The test should be ordered by a clinician to assess the risk of adrenal cortical carcinoma, adenoma, or other adrenal malignancy. It is important to follow the specific guidelines provided by the payer and use the appropriate diagnosis codes to support medical necessity.

8. Historical information

CPT 0015M was added to the Current Procedural Terminology system on October 1, 2020. There have been no updates to the code since its addition.

9. Examples

1. A patient with an adrenal mass undergoes a biochemical assay of 25 steroid markers in a 24-hour urine specimen, along with clinical parameters, to determine the risk of adrenal cortical carcinoma.
2. A clinician orders CPT 0015M for a patient with suspected adrenal malignancy to assess the risk and guide treatment decisions based on the algorithmic analysis.
3. A lab analyst performs the biochemical assay and algorithmic analysis for a patient with an adrenal tumor, providing a risk score for adrenal cortical carcinoma.
4. CPT 0015M is used to evaluate the risk of adrenal malignancy in a patient with abnormal patterns of steroid production in the adrenal gland.
5. A patient with a suspected adrenal adenoma undergoes the biochemical assay of 25 steroid markers in a 24-hour urine specimen, along with clinical parameters, to determine the risk of malignancy.
6. The lab analysis and algorithmic analysis of CPT 0015M help in diagnosing and providing prognostic assistance for a patient with an adrenal cortical tumor.
7. A clinician orders CPT 0015M to assess the risk of adrenal malignancy in a patient with abnormal adrenal gland function.
8. A lab analyst performs the biochemical assay and algorithmic analysis to determine the risk score for adrenal cortical carcinoma in a patient with adrenal abnormalities.
9. CPT 0015M is used to evaluate the risk of adrenal malignancy in a patient with clinical symptoms and findings suggestive of adrenal cortical carcinoma.
10. The algorithmic analysis of CPT 0015M provides a risk score for adrenal malignancy in a patient with an adrenal mass detected on imaging.