How To Use CPT Code 0063U

CPT 0063U describes a proprietary laboratory analysis (PLA) test called the NPDX ASD ADM Panel I test. This test is performed by Stemina Biomarker Discovery, Inc. and is used to evaluate 32 amines in the patient’s plasma using liquid chromatography and mass spectrometry (LC-MS/MS). The test includes an algorithmic analysis of the results to determine if the patient has a metabolic signature associated with autism spectrum disorder (ASD).

1. What is CPT Code 0063U?

CPT 0063U is a unique code that represents the NPDX ASD ADM Panel I test, a proprietary laboratory analysis (PLA) test performed by Stemina Biomarker Discovery, Inc. This test evaluates 32 amines in the patient’s plasma using liquid chromatography and mass spectrometry (LC-MS/MS). The results of the test are then analyzed using an algorithm to determine if the patient has a metabolic signature associated with autism spectrum disorder (ASD).

2. Official Description

The official description of CPT code 0063U is: ‘Neurology (autism), 32 amines by LC-MS/MS, using plasma, algorithm reported as metabolic signature associated with autism spectrum disorder.’

3. Procedure

The patient’s plasma sample is collected for analysis.
The sample is then subjected to liquid chromatography and mass spectrometry (LC-MS/MS) to evaluate the levels of 32 amines.
An algorithmic analysis is performed using the test results and possibly other patient data to determine if the patient has a metabolic signature associated with autism spectrum disorder (ASD).
The results of the analysis are reported as a metabolic signature associated with ASD.

4. Qualifying circumstances

The NPDX ASD ADM Panel I test is ordered by clinicians to aid in the diagnosis of autism spectrum disorder (ASD). It is not limited to testing for a specific condition, but it specifically evaluates the metabolic signature associated with ASD. The test is performed by Stemina Biomarker Discovery, Inc. and uses liquid chromatography and mass spectrometry (LC-MS/MS) to analyze 32 amines in the patient’s plasma.

5. When to use CPT code 0063U

CPT code 0063U should be used when the NPDX ASD ADM Panel I test is performed by Stemina Biomarker Discovery, Inc. to evaluate the metabolic signature associated with autism spectrum disorder (ASD). It is important to note that this code should only be used for the specific test described and should not be reported with any other CPT code.

6. Documentation requirements

To support a claim for CPT code 0063U, the following documentation is required:

Order for the NPDX ASD ADM Panel I test
Date of service
Results of the liquid chromatography and mass spectrometry (LC-MS/MS) analysis
Algorithmic analysis of the test results
Any additional patient data used in the analysis
Report of the metabolic signature associated with autism spectrum disorder (ASD)

7. Billing guidelines

When billing for CPT code 0063U, it is important to use this code only for the NPDX ASD ADM Panel I test performed by Stemina Biomarker Discovery, Inc. Report one unit of this code for a single specimen analyzed on a single date of service. Do not report this test with any other CPT code. Some payers may pay separately for the collection of the specimen, so it is recommended to check with the appropriate payer for their specific guidelines.

8. Historical information

CPT code 0063U was added to the Current Procedural Terminology system on October 1, 2018. There have been no updates or changes to the code since its addition.

9. Examples

A clinician orders the NPDX ASD ADM Panel I test for a child exhibiting symptoms of autism spectrum disorder. The patient’s plasma sample is collected and sent to Stemina Biomarker Discovery, Inc. for analysis. The test results indicate a metabolic signature associated with ASD, confirming the diagnosis.
A pediatrician suspects autism spectrum disorder in a patient and orders the NPDX ASD ADM Panel I test. The patient’s plasma sample is analyzed using liquid chromatography and mass spectrometry (LC-MS/MS), and the algorithmic analysis of the results shows a metabolic signature consistent with ASD.
A child with developmental delays is referred to a specialist who recommends the NPDX ASD ADM Panel I test. The test is performed, and the analysis reveals a metabolic signature associated with autism spectrum disorder, providing valuable information for the patient’s treatment plan.

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