How To Use CPT Code 0310U

CPT 0310U describes a proprietary laboratory analysis (PLA) code that is specific to the HART KD® test from Prevencio, Inc. This article will cover the description, official information, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of CPT code 0310U.

1. What is CPT Code 0310U?

CPT 0310U is a unique PLA code that represents the HART KD® test from Prevencio, Inc. This test analyzes three biomarkers (NT-proBNP, C-reactive protein, and T-uptake) in a plasma specimen to determine the risk score for diagnosing Kawasaki Disease (KD), a pediatric condition with unknown origins that can potentially cause damage to the coronary arteries.

2. Official Description

The official description of CPT code 0310U is a follows: ‘Pediatrics (vasculitis, Kawasaki disease [KD]), analysis of 3 biomarkers (NT-proBNP, C-reactive protein, and T-uptake), plasma, algorithm reported as a risk score for KD.’

3. Procedure

1. The laboratory analyst measures the levels of NT-proBNP, C-reactive protein, and T-uptake in a plasma specimen.
2. The HART KD® kit is used to perform the necessary steps for analyzing the biomarkers.
3. The test utilizes existing laboratory platforms to produce the results.
4. An algorithmic analysis is applied to the results, generating a risk score for diagnosing Kawasaki Disease.

4. Qualifying circumstances

The HART KD® test is ordered by clinicians to facilitate early diagnosis, prognosis, and monitoring of Kawasaki Disease. It is particularly useful for assessing the risk of coronary artery damage in children. The test is specific to the HART KD® kit from Prevencio, Inc., and should only be reported using CPT code 0310U.

5. When to use CPT code 0310U

CPT code 0310U should be used when the HART KD® test is performed using the proprietary kit from Prevencio, Inc. It should not be reported using any other CPT code. The test provides valuable information for diagnosing Kawasaki Disease and assessing the risk of coronary artery damage in pediatric patients.

6. Documentation requirements

To support a claim for CPT code 0310U, the following documentation is required:

• Indication of the need for the HART KD® test for diagnosing Kawasaki Disease
• Identification of the specific biomarkers analyzed (NT-proBNP, C-reactive protein, and T-uptake)
• Date of service and the results of the test
• Explanation of the algorithmic analysis used to generate the risk score
• Signature of the laboratory analyst performing the test

7. Billing guidelines

When billing for CPT code 0310U, ensure that the test is performed using the HART KD® kit from Prevencio, Inc. Report one unit of this code for each individual specimen analyzed on a single date of service. It is important to note that some payers may provide separate reimbursement for specimen collection.

8. Historical information

CPT code 0310U was added to the Current Procedural Terminology system on April 1, 2022. As a proprietary laboratory analysis (PLA) code, it is specific to the HART KD® test from Prevencio, Inc. There have been no updates or changes to the code since its introduction.

9. Examples

1. A pediatrician orders the HART KD® test for a child presenting with symptoms suggestive of Kawasaki Disease. The test analyzes the levels of NT-proBNP, C-reactive protein, and T-uptake in a plasma specimen, providing a risk score for diagnosing the condition.
2. A cardiologist utilizes the HART KD® test to monitor the progress of a pediatric patient with Kawasaki Disease. The test helps assess the risk of coronary artery damage and guides treatment decisions.
3. A pediatric rheumatologist orders the HART KD® test for a child with suspected vasculitis. The test aids in differentiating Kawasaki Disease from other similar conditions and provides valuable diagnostic information.
4. A pediatrician utilizes the HART KD® test as part of a comprehensive evaluation for a child with persistent fever and other symptoms suggestive of Kawasaki Disease. The test helps confirm the diagnosis and assess the risk of complications.
5. A pediatric cardiologist orders the HART KD® test for a newborn with suspected Kawasaki Disease. The test aids in early diagnosis and allows for prompt intervention to prevent potential coronary artery damage.
6. A pediatrician utilizes the HART KD® test to monitor the response to treatment in a child with Kawasaki Disease. The test helps assess the effectiveness of interventions and guides ongoing management.
7. A pediatric rheumatologist orders the HART KD® test for a child with recurrent episodes of fever and other symptoms consistent with Kawasaki Disease. The test aids in confirming the diagnosis and determining the appropriate treatment approach.
8. A pediatric cardiologist utilizes the HART KD® test to assess the risk of coronary artery damage in a child with a history of Kawasaki Disease. The test helps guide long-term management and monitoring of the patient’s cardiovascular health.
9. A pediatrician orders the HART KD® test for a child with persistent fever and other symptoms suggestive of Kawasaki Disease. The test aids in early diagnosis and allows for timely initiation of treatment to minimize potential complications.
10. A pediatric rheumatologist utilizes the HART KD® test to evaluate a child with suspected vasculitis. The test helps differentiate Kawasaki Disease from other similar conditions and provides valuable diagnostic information.