How To Use CPT Code 83950

CPT 83950 describes the measurement of the HER2, neu oncoprotein in a serum 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 83950?

CPT 83950 can be used to measure the HER2, neu oncoprotein in a serum specimen. This test is commonly ordered by clinicians for breast cancer patients to monitor their previous breast cancer diagnosis. The HER2, neu oncoprotein is associated with the ERBB2 gene, which is a member of the epidermal growth factor receptor family.

2. Official Description

The official description of CPT code 83950 is: ‘Oncoprotein; HER-2/neu.’

3. Procedure

1. The lab analyst performs the technical steps to quantitate the HER2, neu oncoprotein in a serum specimen.
2. The most common method used for this measurement is the enzyme linked immunosorbent assay (ELISA), which involves an enzyme linked to an antigen antibody reaction to identify and quantify the analyte.
3. The HER2, neu oncoprotein measurement helps clinicians determine the overexpression of this oncoprotein in breast cancer patients during follow-up and monitoring after treatment.

4. Qualifying circumstances

CPT 83950 is typically used for breast cancer patients who require monitoring of their previous breast cancer diagnosis. The test measures the HER2, neu oncoprotein in a serum specimen to determine its overexpression. It is important to note that this code is specifically for the measurement of the HER2, neu oncoprotein and should not be used for other purposes.

5. When to use CPT code 83950

CPT code 83950 should be used when there is a need to measure the HER2, neu oncoprotein in a serum specimen for breast cancer patients during follow-up and monitoring after treatment. It is not appropriate to use this code for other types of cancer or conditions.

6. Documentation requirements

To support a claim for CPT 83950, the documentation should include:

• Indication for the test, such as follow-up or monitoring of breast cancer
• Methodology used, such as ELISA
• Date of the test
• Results of the HER2, neu oncoprotein measurement
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 83950, ensure that the test is performed on a serum specimen and measures the HER2, neu oncoprotein. It is important to note that some payers may separately reimburse for the collection of the specimen using a different code, such as 36415 for venous blood collection.

8. Historical information

CPT 83950 was added to the Current Procedural Terminology system on January 1, 2002. There was a code change on January 1, 2009, which updated the description to ‘Oncoprotein, HER-2/neu.’

9. Examples

1. A clinician orders CPT 83950 to measure the HER2, neu oncoprotein in a serum specimen for a breast cancer patient during follow-up after treatment.
2. During a routine check-up, a clinician decides to monitor the HER2, neu oncoprotein levels in a breast cancer patient using CPT 83950.
3. A patient with a history of breast cancer undergoes CPT 83950 to assess the overexpression of the HER2, neu oncoprotein as part of their ongoing monitoring.
4. After completing breast cancer treatment, a patient undergoes CPT 83950 to determine the HER2, neu oncoprotein levels for follow-up purposes.
5. A clinician orders CPT 83950 to measure the HER2, neu oncoprotein in a serum specimen to assess the response to a specific treatment in a breast cancer patient.