How To Use CPT Code 80321

CPT 80321 describes the detection and measurement of alcohol biomarkers in a patient 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 80321?

CPT 80321 can be used to describe the test performed by a lab analyst to detect and measure alcohol biomarkers in a patient specimen. Alcohol biomarkers are physiological indicators of alcohol exposure or ingestion. This code specifically tests for one or two alcohol biomarker compounds.

2. Official Description

The official description of CPT code 80321 is: ‘Alcohol biomarkers; 1 or 2.’

3. Procedure

1. The lab analyst performs a test to detect and measure alcohol biomarkers in a patient specimen.
2. The most common test used is an ethyl glucuronide (EtG) test, which detects the presence of ethyl glucuronide in urine or blood samples.
3. The presence of ethyl glucuronide in urine or blood indicates recent alcohol ingestion, with detection possible up to 36 hours in blood and up to 5 days in urine after heavy alcohol use.
4. The test may be quantitative, measuring the exact amount of the biomarker, or qualitative, indicating whether the specimen is positive or negative for the analyte.
5. Other tests may also be used to detect alcohol biomarkers.

4. Qualifying circumstances

CPT 80321 is used when the lab analyst detects one or two alcohol biomarkers in a patient specimen. This test is typically performed to monitor alcohol consumption in individuals who are legally prohibited from drinking alcohol or restricted from drinking by their employers. It is important to note that if three or more alcohol biomarkers are detected, a different CPT code (80322) should be used.

5. When to use CPT code 80321

CPT code 80321 should be used when the lab analyst detects one or two alcohol biomarkers in a patient specimen. It is important to accurately report this code to reflect the specific number of biomarkers detected. If three or more biomarkers are detected, a different CPT code (80322) should be used.

6. Documentation requirements

To support a claim for CPT 80321, the following documentation should be included:

• Indication of the patient’s need for alcohol biomarker testing
• Specific alcohol biomarkers detected
• Date and time of the test
• Results of the test, including quantitative or qualitative findings
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 80321, ensure that the test is performed by a lab analyst and that one or two alcohol biomarkers are detected. It is important to accurately report the number of biomarkers detected. If three or more biomarkers are detected, a different CPT code (80322) should be used. Consider any additional guidelines provided by payers or specific coding guidelines for proper billing.

8. Historical information

CPT 80321 was added to the Current Procedural Terminology system on January 1, 2015. There have been no updates to the code since its addition.

9. Examples

1. A lab analyst detects and measures one alcohol biomarker compound in a patient’s urine sample.
2. A lab analyst detects and measures two alcohol biomarker compounds in a patient’s blood sample.
3. A lab analyst performs an ethyl glucuronide (EtG) test and detects the presence of ethyl glucuronide in a patient’s urine, indicating recent alcohol ingestion.
4. A lab analyst performs an alcohol biomarker test and finds a positive result for one biomarker compound in a patient’s blood sample.
5. A lab analyst performs an alcohol biomarker test and finds a negative result for two biomarker compounds in a patient’s urine sample.
6. A lab analyst detects and measures one alcohol biomarker compound in a patient’s hair sample.
7. A lab analyst detects and measures two alcohol biomarker compounds in a patient’s saliva sample.
8. A lab analyst performs an alcohol biomarker test and finds a positive result for one biomarker compound in a patient’s breath sample.
9. A lab analyst performs an alcohol biomarker test and finds a negative result for two biomarker compounds in a patient’s sweat sample.
10. A lab analyst detects and measures one alcohol biomarker compound in a patient’s nail sample.