How To Use CPT Code 80360

CPT code 80360 describes the measurement or detection of methylphenidate, a central nervous system stimulant used to treat attention deficit disorders, 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 80360?

CPT 80360 can be used to measure or detect the presence of methylphenidate in a patient specimen, such as urine. This code is typically used to help diagnose whether a patient has taken an overdose of methylphenidate or to determine if a patient is complying with a prescribed regimen.

2. Official Description

The official description of CPT code 80360 is: ‘Measurement or detection of methylphenidate; definitive drug testing procedures.’

3. Procedure

1. The lab analyst performs a test to measure or detect the presence of methylphenidate in a patient specimen, such as urine.
2. A methodology, such as liquid chromatography, may be used to separate and analyze the methylphenidate in the specimen.
3. The lab analyst quantitates the methylphenidate, measuring the exact amount of the substance, or determines if the specimen is positive or negative for the analyte.
4. The test may be quantitative, qualitative, or a combination of both.

4. Qualifying circumstances

CPT 80360 may be ordered by clinicians to help diagnose an overdose of methylphenidate or to assess patient compliance with a prescribed regimen. It is not limited to testing for a specific condition.

5. When to use CPT code 80360

CPT code 80360 should be used when there is a need to measure or detect the presence of methylphenidate in a patient specimen. It is appropriate for diagnostic purposes, such as determining overdose or compliance, and may be ordered by clinicians when necessary.

6. Documentation requirements

To support a claim for CPT 80360, documentation should include:

• Patient’s information and reason for testing
• Details of the test performed, including the methodology used
• Date and time of the test
• Results of the test, including the amount of methylphenidate detected or whether the specimen is positive or negative
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 80360, ensure that the test is performed to measure or detect methylphenidate in a patient specimen. Follow the appropriate coding guidelines and consider any additional requirements from payers. It is important to accurately report the service provided and any associated modifiers, if applicable.

8. Historical information

CPT 80360 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 methylphenidate in a patient’s urine specimen to determine if the patient has taken an overdose of the medication.
2. A clinician orders a test to detect the presence of methylphenidate in a patient’s urine specimen to assess the patient’s compliance with a prescribed regimen.
3. A lab analyst uses liquid chromatography to separate and analyze methylphenidate in a patient’s urine specimen, providing a quantitative result of the exact amount of the substance.
4. A clinician orders a test to determine if a patient’s urine specimen is positive or negative for methylphenidate, indicating compliance with a prescribed regimen.
5. A lab analyst performs a test to measure the amount of methylphenidate in a patient’s urine specimen, providing a quantitative result to assist in diagnosing an overdose.
6. A clinician orders a test to detect the presence of methylphenidate in a patient’s urine specimen, which is found to be positive, indicating non-compliance with a prescribed regimen.
7. A lab analyst uses liquid chromatography to separate and analyze methylphenidate in a patient’s urine specimen, providing a qualitative result of the presence of the substance.
8. A clinician orders a test to determine if a patient’s urine specimen is negative for methylphenidate, indicating compliance with a prescribed regimen.
9. A lab analyst performs a test to measure the amount of methylphenidate in a patient’s urine specimen, providing a quantitative result to assist in diagnosing an overdose.
10. A clinician orders a test to detect the presence of methylphenidate in a patient’s urine specimen, which is found to be negative, indicating compliance with a prescribed regimen.