How To Use CPT Code 83018
CPT 83018 describes the quantitative analysis of a specific heavy metal, such as arsenic, barium, beryllium, bismuth, antimony, or mercury. 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 83018?
CPT 83018 is used to measure the level of a specific heavy metal that does not have a separate, distinct code. This code represents a quantitative test for one specific heavy metal, which may be any heavy metal that does not have a different specific CPT code. The test is usually performed on blood, urine, or another liquid source to determine the amount of the heavy metal present in the specimen.
2. Official Description
The official description of CPT code 83018 is: ‘Heavy metal (eg, arsenic, barium, beryllium, bismuth, antimony, mercury); quantitative, each, not elsewhere specified.’ It is important to note that if there is an analyte-specific heavy metal quantitative code available, it should be used instead of CPT 83018.
3. Procedure
- The lab analyst performs the technical steps to determine the amount of a specific heavy metal present in the specimen, such as blood or urine.
- A common test method for heavy metal quantitation is inductively coupled plasma/mass spectrometry, which involves ionizing the sample using inductively coupled plasma and then quantifying the separated ions using mass spectrometry.
4. Qualifying circumstances
CPT 83018 is ordered when there is a need to quantitatively analyze a specific heavy metal in the specimen. This may be based on a positive result from a qualitative heavy metal test or patient symptoms/history indicating possible toxicity or exposure to a specific heavy metal. The test helps clinicians determine appropriate treatment, such as chelation therapy.
5. When to use CPT code 83018
CPT code 83018 should be used when there is a need to quantitatively analyze a specific heavy metal that does not have a separate, more specific CPT code. It should not be reported if there is a separate code available for the specific heavy metal being tested, such as arsenic, lead, or mercury. Additionally, CPT 83018 should not be used for tests that only determine the presence and identity of one or more heavy metals without providing a quantitative measure.
6. Documentation requirements
To support a claim for CPT 83018, the following documentation should be included:
- Patient’s symptoms or history indicating possible toxicity or exposure to a specific heavy metal
- Specific heavy metal being tested
- Date and time of the test
- Quantitative results of the heavy metal analysis
- Signature of the lab analyst performing the test
7. Billing guidelines
When billing for CPT 83018, ensure that the test is performed to quantitatively analyze a specific heavy metal. If there is a separate, more specific CPT code available for the heavy metal being tested, that code should be used instead. It is also important to note that some payers may provide separate reimbursement for specimen collection using a code such as 36415.
8. Historical information
CPT 83018 was added to the Current Procedural Terminology system on January 1, 1990. There have been historical changes to the code, including code changes on January 1, 2003, and January 1, 2017.
9. Examples
- A clinician orders CPT 83018 to quantitatively analyze the level of arsenic in a patient’s blood following a positive result from a qualitative heavy metal test.
- Based on a patient’s symptoms and history of exposure to lead, a clinician requests CPT 83018 to determine the quantity of lead in the patient’s urine.
- After suspecting mercury toxicity in a patient, a clinician orders CPT 83018 to quantitatively analyze the level of mercury in the patient’s hair sample.
- Due to possible beryllium exposure in an industrial setting, a clinician orders CPT 83018 to quantitatively analyze the level of beryllium in a worker’s urine.
- Following a positive result from a qualitative heavy metal test, a clinician requests CPT 83018 to determine the quantity of antimony in a patient’s blood.
