How To Use CPT Code 0145U

CPT 0145U describes a proprietary laboratory analysis (PLA) test called PainViewRx® from Newstar Medical Laboratories LLC. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of CPT code 0145U.

1. What is CPT Code 0145U?

CPT 0145U is a unique code that represents the PainViewRx® test offered by Newstar Medical Laboratories LLC. This test is a definitive urine drug screen that utilizes liquid chromatography with tandem mass spectrometry (LC–MS/MS) and multiple reaction monitoring (MRM) to identify 65 or more drugs or drug metabolites in urine samples. It provides a comprehensive report on possible drug reactions, drug descriptions, and breakdown products, along with sample validation.

2. Official Description

The official description of CPT code 0145U is: ‘Drug assay, definitive, 65 or more drugs or metabolites, urine, quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring (MRM), with drug or metabolite description, comments including sample validation, per date of service.’

3. Procedure

1. The PainViewRx® test uses quantitative liquid chromatography with tandem mass spectrometry (LC–MS/MS) to analyze urine specimens for the presence of 65 or more drugs or drug metabolites.
2. It employs multiple reaction monitoring (MRM) to identify potential drug interactions or adverse drug reactions.
3. Sample validation is performed, which may include genomic sequencing methods to ensure the authenticity of the urine specimen.
4. The test provides a detailed report that includes drug or metabolite descriptions, comments on possible drug reactions, and breakdown products.

4. Qualifying circumstances

The PainViewRx® test is ordered by clinicians to screen for illicit drug use, monitor medication compliance, and evaluate the presence of various drugs, over-the-counter ingredients, and metabolites in urine samples. It is not limited to testing for a specific condition, and it ensures the authenticity of the specimen through sample validation methods.

5. When to use CPT code 0145U

CPT code 0145U should be used when the PainViewRx® test is performed on a urine specimen to identify 65 or more drugs or drug metabolites using LC–MS/MS and MRM. It is important to note that this code is specific to the PainViewRx® test and should not be reported with any other CPT code.

6. Documentation requirements

To support a claim for CPT code 0145U, documentation should include:

• Indication for ordering the PainViewRx® test
• Details of the urine specimen analyzed
• Date of service
• Drug or metabolite descriptions
• Comments on possible drug reactions
• Sample validation information

7. Billing guidelines

When billing for CPT code 0145U, ensure that the test is performed by Newstar Medical Laboratories LLC using the PainViewRx® methodology. Report one unit of this code for each individual specimen analyzed on a single date of service. It is important to note that this code is a proprietary laboratory analysis (PLA) code and takes precedence over other laboratory/pathology codes. Do not report this test with any other CPT code.

8. Historical information

CPT code 0145U, representing the PainViewRx® test, was added to the Current Procedural Terminology system on January 1, 2020. There have been no updates or changes to the code since its addition.

9. Examples

1. A clinician orders the PainViewRx® test to screen for illicit drug use in a patient’s urine sample.
2. The PainViewRx® test is performed to monitor medication compliance in a patient receiving multiple prescriptions.
3. A clinician requests the PainViewRx® test to evaluate the presence of specific drugs and their metabolites in a urine sample.
4. The PainViewRx® test is utilized to ensure the authenticity of a urine specimen before further analysis.
5. A clinician orders the PainViewRx® test to assess possible drug interactions or adverse drug reactions in a patient.
6. The PainViewRx® test is performed to identify the breakdown products of various drugs in a urine sample.
7. A clinician utilizes the PainViewRx® test to evaluate the presence of over-the-counter ingredients in a patient’s urine sample.
8. The PainViewRx® test is ordered to provide a comprehensive drug description and breakdown product report for a specific urine specimen.
9. A clinician requests the PainViewRx® test to assess the presence of drugs or metabolites in a urine sample for forensic purposes.
10. The PainViewRx® test is performed to determine the compliance of an individual undergoing substance abuse treatment.