How To Use CPT Code 80368

CPT 80368 describes the measurement or detection of non-benzodiazepine sedative hypnotics 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 80368?

CPT 80368 can be used to measure or detect the presence of non-benzodiazepine sedative hypnotics in a patient specimen. This code is used when a lab analyst performs a test using methodologies such as gas chromatography or mass spectrometry to identify and quantify these substances in urine or plasma samples.

2. Official Description

The official description of CPT code 80368 is: ‘Measurement or detection of non-benzodiazepine sedative hypnotics in a patient specimen; qualitative or quantitative, all sources, includes specimen validity testing, per day, 1-7 drug class(es), including metabolite(s) if performed.’

3. Procedure

1. The lab analyst collects a patient specimen, such as urine or plasma.
2. The specimen is then subjected to testing using methodologies like gas chromatography or mass spectrometry.
3. The chromatographic method separates and analyzes the analytes in the specimen, while the spectrometric method identifies the resulting elements or molecules by their masses or fragmentation patterns.
4. The lab analyst quantitates the analyte, measuring the exact amount of non-benzodiazepine sedative hypnotics present in the specimen.
5. The test may be qualitative, indicating whether the specimen is positive or negative for the analyte, or quantitative, providing an exact measurement of the substance.
6. Specimen validity testing may also be performed to ensure the integrity of the specimen.

4. Qualifying circumstances

CPT 80368 is ordered by clinicians to help diagnose whether a patient has taken an overdose of non-benzodiazepine sedative hypnotics or to determine if a patient is complying with a prescribed regimen. It is not limited to testing for a specific condition and can be used in various clinical scenarios.

5. When to use CPT code 80368

CPT code 80368 should be used when there is a need to measure or detect non-benzodiazepine sedative hypnotics in a patient specimen. It is appropriate for both qualitative and quantitative testing, and can be used for testing involving one to seven drug classes, including metabolites if performed.

6. Documentation requirements

To support a claim for CPT 80368, the documentation should include:

• Reason for ordering the test, such as suspected overdose or monitoring compliance
• Type of specimen collected (urine, plasma, etc.)
• Methodology used for testing (gas chromatography, mass spectrometry, etc.)
• Results of the test, indicating whether the specimen is positive or negative for non-benzodiazepine sedative hypnotics
• Any additional information relevant to the test, such as specimen validity testing

7. Billing guidelines

When billing for CPT 80368, ensure that the test is performed by a lab analyst using the specified methodologies. The code covers testing for one to seven drug classes, including metabolites if performed. It is important to follow payer-specific guidelines and documentation requirements for accurate billing.

8. Historical information

CPT 80368 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 presence of non-benzodiazepine sedative hypnotics in a urine sample of a patient suspected of overdose.
2. A clinician orders a quantitative test using gas chromatography to monitor a patient’s compliance with a prescribed regimen of non-benzodiazepine sedative hypnotics.
3. A lab analyst uses mass spectrometry to detect the presence of non-benzodiazepine sedative hypnotics in a plasma sample of a patient with suspected substance abuse.
4. A clinician orders a qualitative test to determine if a patient’s urine sample is positive for non-benzodiazepine sedative hypnotics.
5. A lab analyst performs a test to measure the exact amount of non-benzodiazepine sedative hypnotics in a urine sample of a patient undergoing treatment for insomnia.
6. A clinician orders a qualitative test to determine if a patient’s plasma sample is negative for non-benzodiazepine sedative hypnotics.
7. A lab analyst uses gas chromatography to detect the presence of non-benzodiazepine sedative hypnotics in a urine sample of a patient involved in a motor vehicle accident.
8. A clinician orders a quantitative test to measure the concentration of non-benzodiazepine sedative hypnotics in a plasma sample of a patient with a suspected drug overdose.
9. A lab analyst performs a test to detect the presence of non-benzodiazepine sedative hypnotics in a urine sample of a patient undergoing treatment for anxiety.
10. A clinician orders a qualitative test to determine if a patient’s plasma sample is positive for non-benzodiazepine sedative hypnotics.