How To Use CPT Code 83918

CPT 83918 describes the measurement of total organic acids in a patient’s specimen, with a 24-hour urine sample being the preferred 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 83918?

CPT 83918 can be used to measure the total organic acids present in a patient’s specimen. This code is commonly used when analyzing a 24-hour urine sample, as it provides a comprehensive assessment of the organic acids excreted by the patient’s metabolism. Organic acids are byproducts of various metabolic processes, including the breakdown of fatty acids, amino acids, carbohydrates, steroids, and hormones.

2. Official Description

The official description of CPT code 83918 is: ‘Organic acids; total, quantitative, each specimen.’

3. Procedure

1. The lab analyst collects a specimen from the patient, with a 24-hour urine sample being the preferred choice for measuring total organic acids.
2. The specimen is then subjected to a quantitative analysis using liquid chromatography with tandem mass spectrometry.
3. The mass spectrometry process involves bombarding the sample with electrons and then sorting, weighing, and identifying the particles based on their specific fragmentation pattern.
4. The lab analyst quantitates the total organic acids present in the specimen, providing valuable information about the patient’s metabolic byproducts.

4. Qualifying circumstances

CPT 83918 is typically used when clinicians suspect abnormal genetic, organic, or metabolic disorders based on the patient’s total organic acid levels. This test helps in the evaluation and diagnosis of such conditions. It is important to note that this code is not limited to testing for a specific condition but rather provides a comprehensive assessment of the patient’s organic acid excretion.

5. When to use CPT code 83918

CPT code 83918 should be used when there is a clinical need to measure the total organic acids in a patient’s specimen. It is important to consider this code when evaluating abnormal genetic, organic, or metabolic disorders that may be indicated by the patient’s metabolic byproducts. However, clinicians typically order this test when specific single organic acids are not of primary clinical importance.

6. Documentation requirements

To support a claim for CPT 83918, the following documentation is required:

• Indication of the need for total organic acid measurement
• Specimen type used for analysis (preferably a 24-hour urine sample)
• Date and time of specimen collection
• Methodology used for analysis (liquid chromatography with tandem mass spectrometry)
• Results of the quantitative analysis
• Signature of the lab analyst performing the analysis

7. Billing guidelines

When billing for CPT 83918, ensure that the test is performed on a patient’s specimen, with a 24-hour urine sample being the preferred choice. It is important to note that this code should not be reported for each reported analyte but rather for the total organic acids identified from one specimen. Additionally, it is crucial to follow any specific billing guidelines provided by payers regarding the volume measurement for timed urine collection, if applicable.

8. Historical information

CPT 83918 was added to the Current Procedural Terminology system on January 1, 1990. Since its addition, there have been historical changes to the code, including a code change on January 1, 2001, which modified the description to ‘Organic acids; total, quantitative, each specimen.’

9. Examples

1. A patient undergoes a total organic acids test using a 24-hour urine sample to evaluate potential metabolic disorders.
2. A clinician orders a quantitative analysis of total organic acids to assess the patient’s metabolic byproducts and identify any abnormal genetic conditions.
3. A lab analyst performs a comprehensive assessment of the patient’s organic acid excretion using CPT code 83918.
4. A patient’s 24-hour urine sample is analyzed for total organic acids to aid in the diagnosis of organic or metabolic disorders.
5. A clinician utilizes CPT code 83918 to measure the patient’s total organic acids and evaluate their metabolic health.
6. A lab technician performs a quantitative analysis of total organic acids in a patient’s specimen, providing valuable insights into their metabolic processes.
7. A patient’s total organic acids are measured using CPT code 83918 to assess their metabolic function and identify any abnormalities.
8. A clinician orders a total organic acids test to evaluate the patient’s metabolic byproducts and screen for any underlying genetic or organic disorders.
9. A lab analyst quantitates the total organic acids in a patient’s specimen, aiding in the diagnosis of metabolic conditions.
10. CPT code 83918 is used to measure the patient’s total organic acids, providing valuable information about their metabolic health.