How To Use CPT Code 0077U

CPT 0077U describes the qualitative detection of immunoglobulin paraprotein (M-protein) using immunoprecipitation and mass spectrometry on blood or urine samples. This article will provide an overview of CPT code 0077U, including its official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 0077U?

CPT 0077U is a proprietary laboratory analysis (PLA) code that specifically applies to the M-Protein Detection and Isotyping test developed by the Mayo Clinic Laboratory. This test utilizes matrix-assisted laser desorption/ionization (MALDI) and time-of-flight mass spectrometry (TOF-MS) to isolate and identify monoclonal (M-) proteins, also known as paraproteins, in blood or urine samples. The purpose of this test is to aid in the diagnosis of monoclonal gammopathies, which involve an abnormal overproduction of a specific type of immunoglobulin.

2. Official Description

The official description of CPT code 0077U is: ‘Immunoglobulin paraprotein (M-protein), qualitative, immunoprecipitation and mass spectrometry, blood or urine, including isotype.’

3. Procedure

1. The laboratory analyst applies the patient’s blood or urine sample to an affinity matrix column using MALDI technology.
2. The specific proteins, heavy-chain and light-chain immunoglobulins, bind to the affinity matrix column.
3. Time-of-flight mass spectrometry (TOF-MS) is used to identify the isolated monoclonal (M-) proteins, or paraproteins.
4. The results of the test are reported to the clinician, indicating the presence and type of immunoglobulin paraprotein detected.

4. Qualifying circumstances

CPT code 0077U is used when clinicians order the M-Protein Detection and Isotyping test to identify an overabundance of specific immunoglobulins in a patient’s blood or urine sample. This test is particularly relevant in diagnosing monoclonal gammopathies, which involve the increased production of a single type of immunoglobulin. It is important to note that this code should only be used for the specific proprietary test developed by the Mayo Clinic Laboratory.

5. When to use CPT code 0077U

CPT code 0077U should be used when a clinician orders the M-Protein Detection and Isotyping test to aid in the diagnosis of monoclonal gammopathies. This code is specific to the proprietary test developed by the Mayo Clinic Laboratory and should not be reported with any other CPT codes. It is important to verify with payers if they separately reimburse for specimen collection.

6. Documentation requirements

To support a claim for CPT code 0077U, the following documentation is required:

• Patient’s diagnosis or suspected condition warranting the test
• Date of service when the test was performed
• Results of the M-Protein Detection and Isotyping test, including the type of immunoglobulin paraprotein detected
• Signature of the laboratory analyst who performed the test

7. Billing guidelines

When billing for CPT code 0077U, ensure that the test is performed using the specific proprietary method developed by the Mayo Clinic Laboratory. This code should not be reported with any other CPT codes. It is important to check with payers regarding their policies on reimbursement for specimen collection. Additionally, one unit of this code should be reported for each individual specimen analyzed on a single date of service.

8. Historical information

CPT code 0077U, the M-Protein Detection and Isotyping test, was added to the Current Procedural Terminology system on October 1, 2018. As a relatively new code, there have been no updates or changes since its addition.

9. Examples

1. A clinician orders the M-Protein Detection and Isotyping test to identify the presence and type of immunoglobulin paraprotein in a patient’s blood sample, suspecting a monoclonal gammopathy.
2. A patient presents with symptoms suggestive of multiple myeloma, and the clinician orders the M-Protein Detection and Isotyping test to aid in the diagnosis of this condition.
3. A patient with a history of Waldenström macroglobulinemia undergoes regular monitoring using the M-Protein Detection and Isotyping test to assess the levels and type of immunoglobulin paraprotein present.
4. A clinician suspects the presence of monoclonal gammopathy of undetermined significance (MGUS) in a patient and orders the M-Protein Detection and Isotyping test to confirm the diagnosis.
5. A patient with unexplained renal dysfunction undergoes the M-Protein Detection and Isotyping test to investigate the possibility of a monoclonal gammopathy-related kidney disease.
6. A clinician orders the M-Protein Detection and Isotyping test as part of the diagnostic workup for a patient with suspected amyloidosis.
7. A patient with recurrent infections undergoes the M-Protein Detection and Isotyping test to assess the presence and type of immunoglobulin paraprotein that may be contributing to their compromised immune function.
8. A clinician orders the M-Protein Detection and Isotyping test to monitor the response to treatment in a patient with a known monoclonal gammopathy.
9. A patient with persistent fatigue and anemia undergoes the M-Protein Detection and Isotyping test to investigate the possibility of a monoclonal gammopathy-related hematologic disorder.
10. A clinician orders the M-Protein Detection and Isotyping test to evaluate a patient with suspected light-chain deposition disease, a rare kidney disorder associated with monoclonal gammopathies.