How To Use CPT Code 81599

CPT 81599 describes a multianalyte assay with algorithmic analysis, also known as MAAA test, that does not have a specific Category I code or an administrative code in Appendix O. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 81599?

CPT 81599 can be used to report a multianalyte assay with algorithmic analysis, or MAAA test, that does not have a specific Category I code or an administrative code in Appendix O. This code is used when there is no other specific procedure or service code available to accurately represent the service provided by the lab analyst.

2. Official Description

The official description of CPT code 81599 is: ‘Unlisted multianalyte assay with algorithmic analysis.’

3. Procedure

1. The lab analyst performs a multianalyte assay with algorithmic analysis that is not represented by any of the standard and active CPT codes available.

4. Qualifying circumstances

CPT 81599 is used when there is no specific Category I code or administrative code in Appendix O that accurately represents the multianalyte assay with algorithmic analysis performed by the lab analyst. This code should only be used when there is no other appropriate code available to report the service provided.

5. When to use CPT code 81599

CPT code 81599 should be used when there is no specific Category I code or administrative code in Appendix O that accurately represents the multianalyte assay with algorithmic analysis performed by the lab analyst. It is important to note that this code should only be used when there is no other appropriate code available to report the service provided.

6. Documentation requirements

To support a claim for CPT code 81599, the lab analyst must provide a cover letter explaining the reason for choosing the unlisted code instead of a defined, active code. The cover letter should include one or more similar codes and compare the service provided to those codes to justify the claim amount. Additionally, relevant documentation should be included to strengthen the claim and avoid a possible denial.

7. Billing guidelines

When billing for CPT code 81599, it is important to ensure that there is no specific Category I code or administrative code in Appendix O that accurately represents the service provided. If there is a Category III code available, it should be reported instead of using the unlisted procedure code. A cover letter explaining the reason for choosing the unlisted code should be submitted, along with relevant documentation to support the claim.

8. Historical information

CPT code 81599 was added to the Current Procedural Terminology system on January 1, 2013. There have been no updates to the code since its addition.

9. Examples

1. A lab analyst performing a multianalyte assay with algorithmic analysis to detect multiple genetic markers for a specific disease.
2. A laboratory conducting a multianalyte assay with algorithmic analysis to determine the presence and concentration of various biomarkers in a patient’s blood sample.
3. A research facility using a multianalyte assay with algorithmic analysis to analyze a large dataset of patient samples and identify potential correlations between different analytes.
4. A diagnostic laboratory developing a new multianalyte assay with algorithmic analysis to improve the accuracy and efficiency of disease detection.
5. A pharmaceutical company utilizing a multianalyte assay with algorithmic analysis to evaluate the efficacy of a new drug candidate on multiple biological targets.
6. A genetic testing laboratory performing a multianalyte assay with algorithmic analysis to assess an individual’s risk for developing certain hereditary conditions.
7. A clinical laboratory offering a comprehensive multianalyte assay with algorithmic analysis to aid in the diagnosis and management of complex diseases.
8. A molecular diagnostics laboratory using a multianalyte assay with algorithmic analysis to identify specific genetic mutations associated with drug resistance in cancer patients.
9. A research institution conducting a multianalyte assay with algorithmic analysis to investigate the impact of environmental factors on gene expression patterns.
10. A forensic laboratory employing a multianalyte assay with algorithmic analysis to analyze DNA samples from crime scenes and generate genetic profiles for identification purposes.