How To Use CPT Code 80235

CPT 80235 describes the quantification of lacosamide, an antiepileptic medication, 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 80235?

CPT 80235 can be used to quantify the level of lacosamide, an antiepileptic medication, in a patient’s specimen. This code is used when a lab analyst performs the technical lab test to measure the concentration of lacosamide in the patient’s specimen, typically serum. The test is commonly ordered for patients taking lacosamide as an adjunct therapy with other medications to treat partial-onset seizures. It allows clinicians to monitor lacosamide concentrations for compliance, efficacy, and appropriate dosing in cases of renal or hepatic complications.

2. Official Description

The official description of CPT code 80235 is: ‘Quantification of lacosamide, antiepileptic medication, in serum.’

3. Procedure

1. The lab analyst performs all technical steps to measure the level of lacosamide in the patient’s specimen.
2. The most common specimen for this test is serum, which is obtained by the collecting provider as a separate procedure.
3. The test utilizes liquid chromatography-tandem mass spectrometry (LC-MS/MS) as the detection method.
4. The specimen is prepared for analysis using an automated analytical instrument.
5. The instrument separates the components of the specimen through high-pressure liquid chromatography and then ionizes and transfers them to mass spectrometers for identification and quantification based on mass-to-charge ratio.
6. The instrument provides a quantitative result for lacosamide concentration in the specimen.

4. Qualifying circumstances

CPT 80235 is commonly ordered for patients taking lacosamide as an adjunct therapy with other medications to treat partial-onset seizures. It allows clinicians to monitor lacosamide concentrations for compliance, efficacy, and appropriate dosing in cases of renal or hepatic complications. The test can be performed on serum specimens collected from patients of any age.

5. When to use CPT code 80235

CPT code 80235 should be used when there is a need to quantify the level of lacosamide in a patient’s serum specimen. It is appropriate to bill this code when the test is performed to monitor lacosamide concentrations for compliance, efficacy, and appropriate dosing in cases of renal or hepatic complications.

6. Documentation requirements

To support a claim for CPT 80235, the following documentation is required:

• Patient’s diagnosis or indication for lacosamide therapy
• Date of specimen collection
• Specimen type (serum)
• Quantitative result of lacosamide concentration
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 80235, ensure that the test is performed to quantify lacosamide in a patient’s serum specimen. It is important to follow the specific guidelines provided by the payer regarding documentation and coding requirements. It is also essential to review any applicable National Correct Coding Initiative (NCCI) edits to ensure accurate reporting. Additionally, consider reporting any separately billable procedures, such as specimen collection, using the appropriate codes.

8. Historical information

CPT 80235 was added to the Current Procedural Terminology system on January 1, 2020. There have been no updates to the code since its addition.

9. Examples

1. A lab analyst performs the quantification of lacosamide in a patient’s serum specimen to monitor the medication’s concentration for compliance and efficacy.
2. A clinician orders the test to determine the appropriate dosing of lacosamide in a patient with renal complications.
3. The test is performed on a serum specimen from a pediatric patient taking lacosamide as an adjunct therapy for partial-onset seizures.
4. A lab analyst quantifies the level of lacosamide in a patient’s serum specimen to assess its effectiveness in managing seizures.
5. The test is performed on a serum specimen from an adult patient to ensure the compliance and appropriate dosing of lacosamide.
6. A clinician orders the test to monitor the lacosamide concentration in a patient with hepatic complications.
7. A lab analyst performs the quantification of lacosamide in a patient’s serum specimen to evaluate the medication’s therapeutic levels.
8. The test is performed on a serum specimen from a patient taking lacosamide as part of their antiepileptic medication regimen.
9. A clinician orders the test to assess the compliance and efficacy of lacosamide in a patient with partial-onset seizures.
10. The test is performed on a serum specimen from a patient to determine the appropriate dosing of lacosamide based on their renal function.