How To Use CPT Code 80158

CPT 80158 describes the laboratory test used to quantitate the amount of cyclosporine, an immunosuppressant drug, in a patient’s specimen. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 80158?

CPT 80158 can be used to describe the laboratory test performed by a lab analyst to measure the level of cyclosporine present in a patient’s specimen. This test is commonly ordered for patients taking cyclosporine after an organ transplant or as a treatment for rheumatoid arthritis or psoriasis. Monitoring the level of cyclosporine in a patient’s system is important to ensure optimal benefits with minimal side effects. The test can be performed using methods such as liquid chromatography or mass spectrometry.

2. Official Description

The official description of CPT code 80158 is: ‘Cyclosporine; quantitative.’

3. Procedure

1. The lab analyst performs all technical steps to measure the level of cyclosporine present in the patient’s specimen.
2. The most common specimen used for this test is serum, although other specimens may be used.
3. The analyst may use methods such as liquid chromatography or mass spectrometry to detect and quantify the cyclosporine in the specimen.
4. For liquid chromatography, the specimen is mixed with a reagent and passed through a solid material under pressure, allowing the components to be separated and quantified.
5. For mass spectrometry, electrons bombard the atoms or molecules from the sample, and an electric or magnetic field is applied to separate and identify the resulting elements or molecules by their masses or fragmentation patterns.

4. Qualifying circumstances

CPT 80158 may be ordered for patients taking cyclosporine after an organ transplant or as a treatment for rheumatoid arthritis or psoriasis. It is important to monitor the level of cyclosporine in these patients to ensure the medication is at an optimal level for therapeutic benefits while minimizing side effects. The test can be ordered as a trough level, which is a specimen taken right before the next dose when the level should be at its lowest, or as a peak level, which is a specimen taken a few hours after a dose when the level should be at its highest.

5. When to use CPT code 80158

CPT code 80158 should be used when a laboratory test is performed to quantitate the amount of cyclosporine present in a patient’s specimen. It is appropriate to use this code when monitoring the level of cyclosporine in patients taking the medication after an organ transplant or as a treatment for rheumatoid arthritis or psoriasis.

6. Documentation requirements

To support a claim for CPT 80158, the following documentation is required:

• Patient’s diagnosis or indication for cyclosporine therapy
• Specimen type used for the test
• Date and time of specimen collection
• Method used for detection and quantification of cyclosporine
• Results of the test, including the measured level of cyclosporine
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 80158, ensure that the laboratory test is performed to quantitate the amount of cyclosporine in the patient’s specimen. It is important to follow the specific guidelines provided by the payer regarding documentation and coding requirements. Some payers may also separately reimburse for the collection of the specimen using a code such as 36415. It is important to review the payer’s guidelines and policies to ensure accurate and appropriate billing.

8. Historical information

CPT 80158 was added to the Current Procedural Terminology system on January 1, 1993. There have been no updates or changes to the code since its addition.

9. Examples

1. A lab analyst performing a quantitative test to measure the level of cyclosporine in a patient’s serum specimen after a kidney transplant.
2. A clinician ordering a trough level test to monitor the cyclosporine level in a patient with rheumatoid arthritis.
3. A lab technician using liquid chromatography to quantitate the amount of cyclosporine in a patient’s specimen for therapeutic drug monitoring.
4. A physician ordering a peak level test to assess the cyclosporine concentration in a patient’s blood a few hours after a dose.
5. A lab analyst performing a mass spectrometry test to measure the level of cyclosporine in a patient’s specimen for psoriasis treatment monitoring.
6. A clinician ordering a quantitative test to monitor the cyclosporine level in a patient after a heart transplant.
7. A lab technician performing a test to measure the cyclosporine concentration in a patient’s serum specimen for therapeutic drug monitoring.
8. A physician ordering a trough level test to assess the cyclosporine level in a patient with psoriasis.
9. A lab analyst using liquid chromatography to quantitate the amount of cyclosporine in a patient’s specimen for therapeutic drug monitoring.
10. A clinician ordering a peak level test to monitor the cyclosporine concentration in a patient’s blood a few hours after a dose of the medication.