How To Use CPT Code 80356

CPT code 80356 describes the measurement or detection of heroin metabolite 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 80356?

CPT 80356 can be used to measure or detect the presence of heroin metabolite in a patient specimen. This code is used when a lab analyst performs a test using methodologies such as gas chromatography to separate and quantitate the heroin metabolite in the specimen. The test may be quantitative, qualitative, or a combination of both.

2. Official Description

The official description of CPT code 80356 is: ‘Measurement or detection of heroin metabolite(s), qualitative or quantitative; specimen.’ There are no additional notes provided for this code.

3. Procedure

1. The lab analyst receives a patient specimen, which may be urine or blood, for testing.
2. The analyst performs a test using methodologies such as gas chromatography to measure or detect the presence of heroin metabolite in the specimen.
3. If the test is quantitative, the analyst quantitates the exact amount of heroin metabolite in the specimen.
4. If the test is qualitative, the analyst determines whether the specimen is positive or negative for the presence of heroin metabolite.
5. The analyst may use a combination of quantitative and qualitative methods to provide a comprehensive analysis of the specimen.

4. Qualifying circumstances

CPT 80356 is used when clinicians order a test to measure or detect the presence of heroin metabolite in a patient specimen. This test is not limited to a specific condition and may be ordered to help detect heroin metabolite in the specimen or to check for overdose. The test is performed by a lab analyst using methodologies such as gas chromatography.

5. When to use CPT code 80356

CPT code 80356 should be used when there is a need to measure or detect the presence of heroin metabolite in a patient specimen. It is appropriate to bill this code when the lab analyst performs a test using methodologies such as gas chromatography to provide a quantitative or qualitative analysis of the specimen.

6. Documentation requirements

To support a claim for CPT 80356, the following documentation is required:

• Indication for the test and the reason for ordering it
• Type of specimen tested (urine or blood)
• Methodology used for the test (such as gas chromatography)
• Results of the test, including the amount of heroin metabolite if the test is quantitative or whether the specimen is positive or negative if the test is qualitative
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 80356, ensure that the test is performed by a lab analyst using methodologies such as gas chromatography. This code should be reported for the measurement or detection of heroin metabolite in a patient specimen. There are no specific guidelines provided regarding reporting this code with other codes or any additional tips for billing.

8. Historical information

CPT 80356 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 performs a test to measure the amount of heroin metabolite in a urine specimen.
2. A clinician orders a test to detect the presence of heroin metabolite in a blood specimen to check for overdose.
3. A lab analyst uses gas chromatography to quantitate the heroin metabolite in a urine specimen.
4. A patient’s urine specimen is tested qualitatively to determine whether it is positive or negative for the presence of heroin metabolite.
5. A lab analyst performs a comprehensive analysis of a blood specimen, using both quantitative and qualitative methods, to measure and detect heroin metabolite.
6. A clinician orders a test to measure the amount of heroin metabolite in a urine specimen for a patient with a suspected heroin addiction.
7. A lab analyst performs a test to detect the presence of heroin metabolite in a blood specimen to assist in a forensic investigation.
8. A urine specimen is tested qualitatively to determine whether it is positive or negative for the presence of heroin metabolite in a patient undergoing substance abuse treatment.
9. A lab analyst uses gas chromatography to quantitate the heroin metabolite in a blood specimen for a patient participating in a clinical trial.
10. A clinician orders a test to measure the amount of heroin metabolite in a urine specimen to monitor a patient’s progress in substance abuse rehabilitation.