How To Use CPT Code 80185

CPT 80185 describes the laboratory test used to quantitate the total amount of phenytoin, an anticonvulsant medication, present 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 80185?

CPT 80185 can be used to describe the laboratory test performed by a lab analyst to measure the total level of phenytoin in a patient’s specimen. This test is commonly ordered by clinicians to monitor the phenytoin levels in patients with epilepsy or other seizure disorders, ensuring that the prescribed dose is appropriate for the patient.

2. Official Description

The official description of CPT code 80185 is: ‘Phenytoin; total.’

3. Procedure

1. The lab analyst collects a specimen, typically serum, from the patient.
2. The analyst performs the technical steps to measure the total level of phenytoin present in the specimen.
3. The test may involve using an immunoassay method, such as enzyme-linked immunosorbent assay (ELISA), or liquid chromatography.
4. If using an immunoassay method, the analyst reacts the specimen with test antibodies, incubates the mixture, adds an agent to detect the antigen-antibody complex, and quantifies the result.
5. If using liquid chromatography, the analyst mixes the specimen with a reagent and passes the mixture through a solid material under pressure to separate specific components, which are then quantified.

4. Qualifying circumstances

CPT 80185 is not limited to testing for a specific condition but is commonly used to monitor phenytoin levels in patients with epilepsy. The test is performed by a lab analyst, and the specimen collected is typically serum. The test utilizes methods such as immunoassay or liquid chromatography to measure the total amount of phenytoin present in the specimen.

5. When to use CPT code 80185

CPT code 80185 should be used when a clinician orders a laboratory test to quantitate the total amount of phenytoin in a patient’s specimen. This test is commonly used to monitor phenytoin levels in patients with epilepsy or other seizure disorders. It is important to ensure that the test is performed by a lab analyst and that the appropriate specimen, typically serum, is collected.

6. Documentation requirements

To support a claim for CPT 80185, the documentation should include:

• Indication for the test, such as monitoring phenytoin levels in a patient with epilepsy
• Type of specimen collected, typically serum
• Method used for the test, such as immunoassay or liquid chromatography
• Date and time of the test
• Results of the test, indicating the total amount of phenytoin present in the specimen
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 80185, ensure that the test is performed by a lab analyst and that the appropriate specimen, typically serum, is collected. It is important to follow the specific guidelines provided by the payer regarding documentation and coding for this test. Additionally, be aware that some payers may separately reimburse for the collection of the specimen using a separate code, such as 36415.

8. Historical information

CPT 80185 was added to the Current Procedural Terminology system on January 1, 1993. There have been no updates to the code since its addition.

9. Examples

1. A clinician orders CPT 80185 to monitor the phenytoin levels in a patient with epilepsy.
2. A lab analyst performs CPT 80185 to measure the total amount of phenytoin in a patient’s serum specimen.
3. CPT 80185 is used to ensure that the prescribed dose of phenytoin is appropriate for a patient with a seizure disorder.
4. A clinician orders CPT 80185 to monitor the therapeutic levels of phenytoin in a patient receiving anticonvulsant therapy.
5. A lab analyst performs CPT 80185 to quantitate the total amount of phenytoin present in a patient’s specimen, ensuring the medication is within the desired range.
6. CPT 80185 is used to assess the effectiveness of phenytoin therapy in a patient with epilepsy.
7. A clinician orders CPT 80185 to monitor the phenytoin levels in a patient with a history of seizures.
8. A lab analyst performs CPT 80185 to measure the total amount of phenytoin in a patient’s serum specimen, providing valuable information for the clinician’s treatment decisions.
9. CPT 80185 is used to ensure that the patient’s phenytoin levels are within the therapeutic range, optimizing the effectiveness of the anticonvulsant medication.
10. A clinician orders CPT 80185 to monitor the phenytoin levels in a patient with epilepsy, adjusting the medication dosage if necessary.