How To Use CPT Code 80353

CPT 80353 describes the measurement or detection of cocaine 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 80353?

CPT 80353 can be used to measure the amount of or detect the presence of cocaine in a patient specimen. This code is used when a lab analyst performs a test using methodologies such as liquid chromatography or tandem mass spectrometry to analyze the specimen for cocaine. The testing may be quantitative, qualitative, or a combination of both.

2. Official Description

The official description of CPT code 80353 is: ‘Measurement or detection of cocaine or its metabolite(s), qualitative or quantitative; specimen other than urine.’

3. Procedure

1. The lab analyst collects a patient specimen, which can be urine, blood, or serum.
2. The specimen is then analyzed using methodologies such as liquid chromatography or tandem mass spectrometry.
3. The lab analyst measures the amount of or detects the presence of cocaine or its metabolite(s) in the specimen.
4. The test may be qualitative, showing whether the specimen is positive or negative for cocaine, or quantitative, providing the exact amount of cocaine present in the specimen.
5. The lab analyst may use additional techniques or instruments to ensure accurate and reliable results.
6. The results of the test are documented and reported to the ordering clinician.

4. Qualifying circumstances

CPT 80353 is used when clinicians order a test to measure the amount of or detect the presence of cocaine in a patient specimen. This test is not limited to a specific condition and can be ordered to confirm the presence or amount of cocaine in various situations. The specimen can be urine, blood, or serum, and the analysis is performed by a lab analyst using methodologies such as liquid chromatography or tandem mass spectrometry.

5. When to use CPT code 80353

CPT code 80353 should be used when a clinician orders a test to measure the amount of or detect the presence of cocaine in a patient specimen other than urine. This code is appropriate when the analysis is performed using methodologies such as liquid chromatography or tandem mass spectrometry. If the analysis is performed on urine, use CPT code 80356 instead.

6. Documentation requirements

To support a claim for CPT 80353, the clinician must document the following information:

• Reason for ordering the test and the clinical indication
• Type of specimen collected (blood, serum, or other)
• Methodology used for the analysis (liquid chromatography, tandem mass spectrometry, etc.)
• Date and time of specimen collection and analysis
• Results of the analysis, including whether the specimen is positive or negative for cocaine and, if applicable, the exact amount of cocaine present
• Signature of the lab analyst performing the analysis

7. Billing guidelines

When billing for CPT 80353, ensure that the test is performed on a specimen other than urine and that the analysis is done using methodologies such as liquid chromatography or tandem mass spectrometry. It is important to follow the specific guidelines provided by the payer regarding documentation and reporting of this code. Some payers may also separately reimburse for specimen collection using a code such as 36415. It is recommended to review the payer’s policies and guidelines for accurate billing and reimbursement.

8. Historical information

CPT 80353 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 clinician orders a test to measure the amount of cocaine in a blood specimen collected from a suspected drug overdose patient.
2. A lab analyst performs an analysis to detect the presence of cocaine in a serum specimen collected from a patient involved in a motor vehicle accident.
3. A clinician orders a test to confirm the presence of cocaine in a blood specimen collected from a patient undergoing substance abuse treatment.
4. A lab analyst measures the amount of cocaine in a serum specimen collected from a professional athlete as part of a drug testing program.
5. A clinician orders a test to detect the presence of cocaine in a blood specimen collected from a newborn baby suspected of exposure to drugs during pregnancy.
6. A lab analyst performs an analysis to measure the amount of cocaine in a serum specimen collected from a patient with a history of substance abuse.
7. A clinician orders a test to confirm the presence of cocaine in a blood specimen collected from a patient involved in a criminal investigation.
8. A lab analyst measures the amount of cocaine in a serum specimen collected from a patient admitted to the emergency department with symptoms of drug intoxication.
9. A clinician orders a test to detect the presence of cocaine in a blood specimen collected from a patient undergoing pre-employment drug screening.
10. A lab analyst performs an analysis to measure the amount of cocaine in a serum specimen collected from a patient enrolled in a clinical research study on drug metabolism.