How To Use CPT Code 80190

CPT 80190 describes the laboratory test used to analyze the amount of procainamide, a medication for heart arrhythmias, 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 80190?

CPT 80190 is a laboratory test used to measure the level of procainamide in a patient’s specimen. Procainamide is a medication commonly prescribed by clinicians to treat heart arrhythmias. This test is performed by a lab analyst who analyzes the specimen, typically serum, using a variety of techniques such as immunoassay methods like enzyme-linked immunosorbent assay (ELISA). The test quantitates the amount of procainamide present in the specimen, allowing clinicians to monitor the patient’s levels and ensure they are within the therapeutic range.

2. Official Description

The official description of CPT code 80190 is: ‘Procainamide; lab analysis.’

3. Procedure

1. The lab analyst receives the patient’s specimen, usually serum, for analysis.
2. The analyst performs various technical steps to measure the level of procainamide present in the specimen.
3. Common methods of detection include immunoassay techniques like ELISA, which involve reacting the specimen with test antibodies, incubating the mixture, and quantifying the result.
4. The analyst may use stains, fluorescent markers, or other agents to detect the antigen-antibody complex formed during the reaction.
5. The level of procainamide in the specimen is quantitated, providing valuable information for clinicians to monitor the patient’s medication dosage.

4. Qualifying circumstances

CPT 80190 is typically ordered by clinicians to monitor patients who are taking procainamide for heart arrhythmias. The test ensures that the patient is receiving the correct dosage of the medication and that their levels are within the therapeutic range. It is not limited to testing for a specific condition and can be used for any patient taking procainamide. The specimen collected for analysis is usually serum, and the test is performed by a lab analyst.

5. When to use CPT code 80190

CPT code 80190 should be used when a clinician orders a laboratory test to measure the level of procainamide in a patient’s specimen. This test is particularly relevant for patients who are taking procainamide for heart arrhythmias, as it helps ensure that the medication dosage is appropriate and within the therapeutic range. It is important to note that CPT code 80190 should not be used for testing procainamide with metabolites, as a separate code, such as 80192, should be used in that case.

6. Documentation requirements

To support a claim for CPT code 80190, the documentation should include:

• The clinician’s order for the laboratory test
• The patient’s diagnosis or indication for procainamide therapy
• The type of specimen collected for analysis (e.g., serum)
• The date and time of specimen collection
• The laboratory test results indicating the level of procainamide present
• The signature of the lab analyst who performed the test

7. Billing guidelines

When billing for CPT code 80190, ensure that the test is performed by a lab analyst and that the documentation requirements are met. It is important to note that some payers may separately reimburse for the collection of the specimen using a code such as 36415. Additionally, if the clinician orders procainamide with metabolites, CPT code 80192 should be used instead of 80190. Familiarize yourself with the specific billing guidelines of the payer to ensure accurate reimbursement.

8. Historical information

CPT code 80190 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 clinician orders CPT code 80190 to measure the level of procainamide in a patient’s serum specimen to ensure the patient is receiving the appropriate dosage for their heart arrhythmia.
2. A patient taking procainamide for an irregular heart rate undergoes CPT code 80190 to monitor their medication levels and adjust the dosage if necessary.
3. A clinician suspects that a patient’s procainamide levels may be too high, leading to potential side effects, and orders CPT code 80190 to confirm the suspicion and adjust the medication dosage accordingly.
4. A patient with a history of heart arrhythmias undergoes CPT code 80190 to establish a baseline level of procainamide in their system before starting the medication.
5. A clinician orders CPT code 80190 to monitor the procainamide levels in a patient who recently started the medication to ensure they are within the therapeutic range.
6. A patient with a known sensitivity to procainamide undergoes CPT code 80190 to monitor their levels and prevent adverse reactions.
7. A clinician orders CPT code 80190 to measure the procainamide levels in a patient’s serum specimen as part of routine monitoring for patients on long-term procainamide therapy.
8. A patient with a history of heart arrhythmias undergoes CPT code 80190 to assess the effectiveness of their current procainamide dosage and make any necessary adjustments.
9. A clinician orders CPT code 80190 to measure the procainamide levels in a patient’s serum specimen before and after a dosage adjustment to evaluate the medication’s impact on their heart arrhythmia.
10. A patient taking procainamide for an irregular heart rate undergoes CPT code 80190 to ensure their medication levels remain within the therapeutic range and prevent potential complications.