How To Use CPT Code 0123U

CPT 0123U describes a proprietary laboratory analysis (PLA) test called Mechanical Fragility, RBC, shear stress and spectral analysis profiling. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 0123U?

CPT 0123U can be used to report the Mechanical Fragility, RBC, shear stress and spectral analysis profiling test. This test is performed by Functional Fluidics using spectrophotometry to analyze the absorption spectrum of a red blood cell (RBC) sample. It determines the susceptibility of RBCs to hemolysis (mechanical fragility) without the need for centrifugation or sample separation.

2. Official Description

The official description of CPT code 0123U is: ‘Mechanical fragility, RBC, shear stress and spectral analysis profiling.’

3. Procedure

1. The lab analyst places the blood sample in a flexible sample chamber.
2. The sample is exposed to ultraviolet or infrared light and shear stress by compression of the chamber.
3. A spectrophotometer collects the light that passes through the chamber.
4. A computer analyzes the absorption spectrum of the sample.
5. The result is reported as a fraction or proportion of hemolysis (rupture) of the RBCs.

4. Qualifying circumstances

This test is ordered by clinicians for patients undergoing blood transfusions or who may have a blood interaction with drugs or implanted devices. It is used to assess the susceptibility of RBCs to hemolysis and determine the potential risks associated with blood-related procedures or treatments.

5. When to use CPT code 0123U

CPT code 0123U should be used when reporting the Mechanical Fragility, RBC, shear stress and spectral analysis profiling test. It is important to ensure that this code is only used for the specific proprietary test described and not reported with any other CPT code.

6. Documentation requirements

To support a claim for CPT code 0123U, the following documentation is required:

• Indication for the test and the clinical need
• Date of service
• Results of the test, including the fraction or proportion of hemolysis
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT code 0123U, ensure that the test is performed by Functional Fluidics and that it meets the criteria for a proprietary laboratory analysis (PLA) test. This code should not be reported with any other CPT code. It is also advisable to check with the appropriate payer regarding separate payment for specimen collection.

8. Historical information

CPT code 0123U was added to the Current Procedural Terminology system on October 1, 2019. There have been no updates to the code since its addition.

9. Examples

1. A patient undergoing a blood transfusion requires the Mechanical Fragility, RBC, shear stress and spectral analysis profiling test to assess the susceptibility of their red blood cells to hemolysis.
2. A patient with an implanted device needs to undergo the Mechanical Fragility, RBC, shear stress and spectral analysis profiling test to evaluate the potential risks of blood interaction with the device.
3. A clinician orders the Mechanical Fragility, RBC, shear stress and spectral analysis profiling test for a patient who will be starting a new medication that may have an impact on their red blood cells.
4. A patient with a history of blood-related complications requires the Mechanical Fragility, RBC, shear stress and spectral analysis profiling test to assess their risk for future procedures.
5. A patient with a suspected blood disorder undergoes the Mechanical Fragility, RBC, shear stress and spectral analysis profiling test to aid in diagnosis and treatment planning.
6. A clinician orders the Mechanical Fragility, RBC, shear stress and spectral analysis profiling test for a patient with a known sensitivity to blood products to determine the appropriate course of action for their medical care.
7. A patient with a complex medical condition requires the Mechanical Fragility, RBC, shear stress and spectral analysis profiling test to assess the potential risks associated with their condition and guide treatment decisions.
8. A clinician orders the Mechanical Fragility, RBC, shear stress and spectral analysis profiling test for a patient who will be undergoing a surgical procedure that may involve blood transfusion.
9. A patient with a history of adverse reactions to certain medications needs the Mechanical Fragility, RBC, shear stress and spectral analysis profiling test to evaluate the potential risks of blood interaction with those medications.
10. A clinician orders the Mechanical Fragility, RBC, shear stress and spectral analysis profiling test for a patient with a suspected genetic blood disorder to aid in diagnosis and genetic counseling.