How To Use CPT Code 0308U

CPT 0308U describes a proprietary laboratory analysis (PLA) code for the assessment of three proteins in plasma to determine the risk score for obstructive coronary artery disease (CAD). This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of CPT code 0308U.

1. What is CPT Code 0308U?

CPT 0308U is a unique PLA code that applies to a specific laboratory test called HART CADhs® from Prevencio Inc. This test analyzes the levels of three proteins in plasma: high sensitivity (hs) troponin, adiponectin, and kidney injury molecule-1 (KIM-1). By using an algorithmic analysis of the results and patient data, the test provides a risk score for stenosis or obstruction of a coronary artery, which can help guide treatment decisions.

2. Official Description

The official description of CPT code 0308U is: ‘Cardiology (coronary artery disease [CAD]), analysis of 3 proteins (high sensitivity [hs] troponin, adiponectin, and kidney injury molecule-1 [KIM-1]), plasma, algorithm reported as a risk score for obstructive CAD.’

3. Procedure

1. The laboratory analyst measures the levels of high sensitivity (hs) troponin, adiponectin, and kidney injury molecule-1 (KIM-1) in a plasma specimen.
2. The HART CADhs® kit is used to perform the analysis on existing laboratory platforms.
3. The test utilizes an algorithmic analysis that incorporates the plasma protein level results, patient sex, age, and prior percutaneous coronary intervention to determine the risk score for obstructive CAD.
4. The risk score provides information on the patient’s likelihood of developing coronary artery stenosis or obstruction, which can guide the selection of appropriate management options.

4. Qualifying circumstances

CPT code 0308U is used for patients who require an assessment of their risk for obstructive coronary artery disease (CAD). The test analyzes the levels of three specific proteins in plasma and uses an algorithmic analysis to determine the risk score. This code is specific to the HART CADhs® test from Prevencio Inc. and should only be reported for this particular test.

5. When to use CPT code 0308U

CPT code 0308U should be used when there is a need to assess the risk of obstructive coronary artery disease (CAD) in a patient. This code is specific to the HART CADhs® test and should not be reported for any other laboratory test. It is important to ensure that the test is performed by the appropriate laboratory and that the results are reported as a risk score for obstructive CAD.

6. Documentation requirements

To support a claim for CPT code 0308U, the documentation should include:

• Identification of the specific test performed, which is the HART CADhs® test
• Date of service and the patient’s information
• Results of the analysis, including the levels of high sensitivity (hs) troponin, adiponectin, and kidney injury molecule-1 (KIM-1)
• Algorithmic analysis and the reported risk score for obstructive CAD
• Signature of the laboratory analyst performing the test

7. Billing guidelines

When billing for CPT code 0308U, it is important to ensure that the test is performed by Prevencio Inc. for the HART CADhs® test. This code should not be reported for any other laboratory test. It is also important to follow any specific billing guidelines provided by the payer or insurance company. Report one unit of this code for each individual specimen analyzed on a single date of service.

8. Historical information

CPT code 0308U was added to the Current Procedural Terminology system on April 1, 2022. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient undergoes the HART CADhs® test to assess their risk for obstructive coronary artery disease (CAD). The test analyzes the levels of high sensitivity (hs) troponin, adiponectin, and kidney injury molecule-1 (KIM-1) in their plasma specimen and provides a risk score based on an algorithmic analysis.
2. A cardiologist orders the HART CADhs® test for a patient with symptoms suggestive of coronary artery disease. The test results help guide the selection of appropriate management options based on the patient’s risk score for obstructive CAD.
3. An individual with a family history of coronary artery disease undergoes the HART CADhs® test to assess their own risk. The test provides valuable information for preventive measures and treatment decisions.
4. A patient who has previously undergone percutaneous coronary intervention undergoes the HART CADhs® test to monitor their risk for obstructive CAD. The risk score obtained from the test helps guide their ongoing management and follow-up care.
5. A primary care physician orders the HART CADhs® test for a patient with multiple risk factors for coronary artery disease. The test results assist in determining the appropriate level of intervention and treatment for the patient.
6. A patient presents with symptoms suggestive of obstructive coronary artery disease and undergoes the HART CADhs® test to assess their risk. The risk score obtained from the test helps guide the decision-making process for further diagnostic tests and treatment options.
7. A healthcare provider orders the HART CADhs® test for a patient with atypical symptoms of coronary artery disease. The test results provide additional information to aid in the diagnosis and management of the patient’s condition.
8. An individual with a history of coronary artery disease undergoes the HART CADhs® test as part of their routine follow-up care. The test results assist in monitoring their ongoing risk for obstructive CAD and guide their long-term management.
9. A patient with risk factors for coronary artery disease, such as obesity and hypertension, undergoes the HART CADhs® test to assess their risk. The test results help guide lifestyle modifications and treatment decisions to reduce their risk of developing obstructive CAD.
10. A cardiologist orders the HART CADhs® test for a patient with chest pain and other symptoms suggestive of coronary artery disease. The risk score obtained from the test assists in determining the appropriate course of action, such as further diagnostic tests or intervention.