How To Use CPT Code 0121U

CPT 0121U describes a proprietary laboratory analysis (PLA) test called the Flow Adhesion of Whole Blood on VCAM-1 (FAB-V) test. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of CPT code 0121U.

1. What is CPT Code 0121U?

CPT 0121U is a PLA code that represents the Flow Adhesion of Whole Blood on VCAM-1 (FAB-V) test. This test is performed by Functional Fluidics and is used to assess the effects of drugs in preventing cell adhesion in patients with sickle cell disease (SCD). The FAB-V test is a flow-based cell adhesion assay that analyzes whole blood samples to evaluate the therapeutic effects of antiadhesion medications in patients with SCD.

2. Official Description

The official description of CPT code 0121U is: ‘Flow Adhesion of Whole Blood on VCAM-1 (FAB-V) test from Functional Fluidics, a flow-based cell adhesion assay performed on whole blood to assess the effects of drugs to prevent cell adhesion in patients with sickle cell disease.’

3. Procedure

1. The lab analyst performs microfluidic flow-based cell adhesion analysis of whole blood samples on vascular cell adhesion molecule-1 (VCAM-1) at baseline or following drug treatment.
2. Whole blood is subjected to physiologic flow across an adhesive VCAM-1 substrate.
3. Pretreated isolated leukocytes are perfused through microfluidic channels coated with VCAM-1.
4. Time-lapse images are used to measure cell rolling/sliding along the channel surface.
5. Proprietary software enables the selection and representation of cell movements by speed and vector, reflecting the interaction between the selectins and ligands, and generates a dynamic adhesion index (dAI) from mean velocity for rolling objects and cell flux.

4. Qualifying circumstances

The FAB-V test is ordered by clinicians for patients with sickle cell disease (SCD). SCD is a group of inherited red blood cell disorders characterized by abnormal protein in the red blood cells, resulting in a curved sickle shape and various complications. The FAB-V test helps providers assess the therapeutic effects of antiadhesion medications in patients with SCD, potentially preventing pain crises, organ damage, and early morbidity and mortality from vascular occlusion.

5. When to use CPT code 0121U

CPT code 0121U should be used when reporting the Flow Adhesion of Whole Blood on VCAM-1 (FAB-V) test performed by Functional Fluidics. This code is specific to the proprietary test and should not be reported with any other CPT code. It is important to distinguish CPT code 0121U from other PLA codes related to microfluidic flow adhesion tests, such as CPT code 0122U for microfluidic flow adhesion relative to P-Selectin.

6. Documentation requirements

To support a claim for CPT code 0121U, the following documentation is required:

• Indication of sickle cell disease (SCD) in the patient
• Documentation of the Flow Adhesion of Whole Blood on VCAM-1 (FAB-V) test performed by Functional Fluidics
• Date of service and results of the test
• Signature of the lab analyst who performed the test

7. Billing guidelines

When billing for CPT code 0121U, ensure that the test is performed by Functional Fluidics and that the documentation requirements are met. This code should only be reported for the FAB-V test and should not be reported with any other CPT code. It is important to check with the appropriate payer regarding payment for specimen collection, as some payers may reimburse separately for this service.

8. Historical information

CPT code 0121U, representing the Flow Adhesion of Whole Blood on VCAM-1 (FAB-V) test, was added to the Current Procedural Terminology system on October 1, 2019. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient with sickle cell disease undergoes the Flow Adhesion of Whole Blood on VCAM-1 (FAB-V) test to assess the effects of a new antiadhesion medication.
2. A clinician orders the FAB-V test for a patient with sickle cell disease to evaluate the therapeutic effects of a current antiadhesion medication.
3. A laboratory performs the FAB-V test on a whole blood sample from a patient with sickle cell disease to determine the patient’s response to a specific drug treatment.
4. A patient with sickle cell disease undergoes the FAB-V test as part of a clinical trial studying the efficacy of different antiadhesion medications.
5. A provider orders the FAB-V test for a patient with sickle cell disease to monitor the effects of a long-term antiadhesion medication regimen.
6. A laboratory performs the FAB-V test on a whole blood sample from a patient with sickle cell disease to assess the patient’s risk of vascular occlusion.
7. A clinician orders the FAB-V test for a patient with sickle cell disease to determine the appropriate dosage of an antiadhesion medication.
8. A patient with sickle cell disease undergoes the FAB-V test to evaluate the effectiveness of a newly developed antiadhesion medication.
9. A laboratory performs the FAB-V test on a whole blood sample from a patient with sickle cell disease to assess the patient’s response to a change in antiadhesion medication.
10. A provider orders the FAB-V test for a patient with sickle cell disease to monitor the patient’s progress during a treatment plan involving antiadhesion medications.