How To Use CPT Code 83630

CPT 83630 describes the qualitative analysis of lactoferrin in a stool 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 83630?

CPT 83630 can be used to describe the qualitative analysis of lactoferrin in a stool specimen. This code is used when a lab analyst performs a technical test to determine the presence of lactoferrin, which is an indicator of inflammation in the intestinal tract.

2. Official Description

The official description of CPT code 83630 is: ‘Lactoferrin, fecal; qualitative.’

3. Procedure

1. The lab analyst performs a qualitative technical test on a stool specimen to detect the presence of lactoferrin.
2. The test typically uses an enzyme-linked immunosorbent assay (ELISA) method to identify and quantitate lactoferrin in the specimen.
3. Lactoferrin is a protein produced by certain white blood cells in response to bacterial infection and inflammation.
4. The presence of lactoferrin indicates inflammatory conditions such as inflammatory bowel disease (IBD), intestinal infection, or colon cancer.
5. Low levels of lactoferrin may indicate noninflammatory conditions such as irritable bowel syndrome (IBS) or viral infection.

4. Qualifying circumstances

CPT 83630 is typically ordered when a patient has persistent bloody or watery diarrhea, which may indicate inflammatory gastrointestinal conditions. The test helps differentiate between noninflammatory and inflammatory conditions. It is important to note that this test is not limited to a specific condition and can be used to detect lactoferrin in various inflammatory and noninflammatory conditions.

5. When to use CPT code 83630

CPT code 83630 should be used when a qualitative analysis of lactoferrin in a stool specimen is performed. It is appropriate to bill this code when the lab analyst performs the test to determine the presence or absence of lactoferrin. This code should not be used for quantitative analysis of lactoferrin, which requires a different CPT code (83631).

6. Documentation requirements

To support a claim for CPT 83630, the documentation should include:

• Reason for ordering the test, such as persistent bloody or watery diarrhea
• Details of the qualitative test performed, including the method used (ELISA)
• Results of the lactoferrin analysis
• Interpretation of the results and their significance in relation to the patient’s condition
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 83630, ensure that the test is performed by a lab analyst and that it is a qualitative analysis of lactoferrin in a stool specimen. This code should not be reported with CPT code 83631, which is used for quantitative analysis of lactoferrin. It is important to follow the specific guidelines provided by the payer and use the appropriate modifiers if required.

8. Historical information

CPT 83630 was added to the Current Procedural Terminology system on January 1, 2005. There have been no updates or changes to the code since its addition.

9. Examples

1. A lab analyst performs a qualitative analysis of lactoferrin in a stool specimen to determine the presence of inflammation in the intestinal tract.
2. A patient with persistent bloody diarrhea undergoes a qualitative analysis of lactoferrin in a stool specimen to help diagnose the underlying cause of their symptoms.
3. A gastroenterologist orders a qualitative analysis of lactoferrin in a stool specimen to differentiate between inflammatory and noninflammatory gastrointestinal conditions in a patient with chronic diarrhea.
4. A primary care physician requests a qualitative analysis of lactoferrin in a stool specimen for a patient with suspected inflammatory bowel disease.
5. A lab technician performs a qualitative analysis of lactoferrin in a stool specimen to assess the presence of inflammation in a patient with suspected colon cancer.
6. A pediatrician orders a qualitative analysis of lactoferrin in a stool specimen to evaluate a child with persistent watery diarrhea.
7. A gastroenterologist utilizes a qualitative analysis of lactoferrin in a stool specimen to monitor the response to treatment in a patient with inflammatory bowel disease.
8. A patient with suspected irritable bowel syndrome undergoes a qualitative analysis of lactoferrin in a stool specimen to rule out inflammatory conditions.
9. A lab analyst performs a qualitative analysis of lactoferrin in a stool specimen to assess the effectiveness of treatment in a patient with intestinal infection.
10. A gastroenterologist orders a qualitative analysis of lactoferrin in a stool specimen to screen for inflammation in a patient at risk for inflammatory bowel disease.