How To Use CPT Code 80354

CPT 80354 describes the procedure for measuring the amount of or detecting the presence of fentanyl in a patient specimen. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 80354?

CPT 80354 can be used to measure the amount of or detect the presence of fentanyl in a patient specimen. This code is used when a lab analyst performs a test using a methodology such as liquid chromatography to separate fentanyl from the specimen and quantitate the analyte. The testing may be quantitative, qualitative, or a combination of both.

2. Official Description

The official description of CPT code 80354 is: ‘Measurement of fentanyl or fentanyl metabolite(s) in a biological specimen; definitive drug testing procedures (e.g., liquid chromatography, mass spectrometry)’

3. Procedure

1. The lab analyst collects a patient specimen, such as urine or serum.
2. The lab analyst uses a methodology, such as liquid chromatography, to separate fentanyl from the specimen.
3. The solvent is dried, and the analyte, which is the substance being measured, separates from the mixture.
4. A sensitive detector is used to quantitate the analyte, measuring the exact amount of fentanyl present in the specimen.
5. The lab analyst may also perform qualitative testing to determine if the specimen is positive or negative for fentanyl.
6. The lab analyst may use a combination of quantitative and qualitative testing methods.

4. Qualifying circumstances

CPT 80354 is used when clinicians order a test to measure the level of fentanyl in a patient specimen. This test may be ordered to check compliance with a prescribed regimen or in cases of suspected overdose. The specimen can be urine or serum, and the test is performed by a lab analyst using definitive drug testing procedures such as liquid chromatography or mass spectrometry.

5. When to use CPT code 80354

CPT code 80354 should be used when there is a need to measure the amount of or detect the presence of fentanyl in a patient specimen using definitive drug testing procedures. It is appropriate to bill this code when the lab analyst performs the test and provides the results.

6. Documentation requirements

To support a claim for CPT 80354, the following documentation is required:

• Patient’s information and specimen details
• Methodology used for testing, such as liquid chromatography or mass spectrometry
• Date and time of the test
• Results of the test, including the amount of fentanyl detected or whether the specimen is positive or negative
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 80354, ensure that the test is performed by a lab analyst using definitive drug testing procedures. It is important to follow the specific guidelines provided by the payer regarding billing for specimen collection. CPT code 80354 should not be reported with other codes unless specified by the payer.

8. Historical information

CPT 80354 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 measures the amount of fentanyl in a urine specimen to determine if a patient is compliant with their prescribed pain management regimen.
2. A clinician suspects a patient has overdosed on fentanyl and orders a test to detect the presence of the drug in their serum specimen.
3. A lab analyst performs a quantitative test to measure the exact amount of fentanyl in a urine specimen for forensic purposes.
4. A patient is undergoing treatment for substance abuse and regular testing is conducted to monitor their fentanyl levels in urine specimens.
5. A healthcare provider orders a test to determine if a patient has been exposed to fentanyl by measuring the presence of the drug in their hair specimen.
6. A lab analyst performs a qualitative test to determine if a urine specimen is positive or negative for fentanyl in a workplace drug testing program.
7. A clinician orders a test to measure the amount of fentanyl in a serum specimen to assess the effectiveness of a patient’s pain management regimen.
8. A lab analyst performs a test to detect the presence of fentanyl in a urine specimen as part of a pre-employment drug screening process.
9. A patient presents with symptoms of fentanyl overdose, and a test is ordered to confirm the presence of the drug in their serum specimen.
10. A lab analyst performs a test to measure the amount of fentanyl in a urine specimen to assess a patient’s compliance with their pain medication regimen.