How To Use CPT Code 83951

CPT 83951 describes the measurement of the des gamma carboxy prothrombin oncoprotein, typically 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 83951?

CPT 83951 can be used to measure the des gamma carboxy prothrombin (DCP) oncoprotein in a serum sample. This test is commonly performed by lab analysts using the enzyme linked immunosorbent assay (ELISA) methodology. The DCP oncoprotein is an abnormal protein induced by the vitamin K antagonist II, which is an abnormal form of nonfunctional prothrombin.

2. Official Description

The official description of CPT code 83951 is: ‘Oncoprotein; des-gamma-carboxy-prothrombin (DCP).’ There are no additional notes or modifiers specified for this code.

3. Procedure

1. The lab analyst collects a serum specimen from the patient.
2. The lab analyst performs the technical steps to quantitate the DCP oncoprotein using the ELISA methodology.
3. The enzyme linked immunosorbent assay involves an enzyme linked to an antigen antibody reaction to identify and quantify the DCP oncoprotein.
4. The lab analyst measures the DCP oncoprotein levels in the serum sample.

4. Qualifying circumstances

CPT 83951 is typically used for the risk assessment and monitoring of hepatocellular carcinoma, a primary malignant cancer of the liver. It is also used to assess the risk of hepatocellular carcinoma development in patients with chronic liver disease. The test is performed on serum samples, and there are no specific qualifying circumstances mentioned for this code.

5. When to use CPT code 83951

CPT code 83951 should be used when measuring the des gamma carboxy prothrombin oncoprotein in a serum specimen. It is appropriate to use this code for the risk assessment and monitoring of hepatocellular carcinoma, as well as for assessing the risk of hepatocellular carcinoma development in patients with chronic liver disease.

6. Documentation requirements

To support a claim for CPT code 83951, the documentation should include:

• Indication for the test, such as risk assessment or monitoring of hepatocellular carcinoma
• Type of specimen collected (serum)
• Methodology used (enzyme linked immunosorbent assay)
• Results of the DCP oncoprotein measurement

7. Billing guidelines

When billing for CPT code 83951, ensure that the test is performed on a serum specimen and that the documentation supports the medical necessity for the test. There are no specific billing guidelines or modifiers mentioned for this code.

8. Historical information

CPT code 83951 was added to the Current Procedural Terminology system on January 1, 2009. There have been no updates or changes to this code since its addition.

9. Examples

1. A lab analyst measures the DCP oncoprotein levels in a serum sample to assess the risk of hepatocellular carcinoma in a patient with chronic liver disease.
2. A clinician orders the DCP oncoprotein test for a patient with suspected hepatocellular carcinoma to aid in the diagnosis and monitoring of the disease.
3. A patient with a history of hepatocellular carcinoma undergoes regular DCP oncoprotein testing to monitor the effectiveness of their treatment.
4. A healthcare provider uses the DCP oncoprotein test to assess the risk of hepatocellular carcinoma development in a patient with chronic liver disease.
5. A lab analyst performs the DCP oncoprotein test on a serum specimen to assist in the early detection of hepatocellular carcinoma in a high-risk individual.
6. A clinician orders the DCP oncoprotein test as part of a comprehensive liver cancer screening program for patients with risk factors for hepatocellular carcinoma.
7. A patient with a family history of hepatocellular carcinoma undergoes regular DCP oncoprotein testing to monitor their risk of developing the disease.
8. A healthcare provider uses the DCP oncoprotein test to assess the effectiveness of a patient’s treatment for hepatocellular carcinoma.
9. A lab analyst measures the DCP oncoprotein levels in a serum sample to aid in the prognosis and risk assessment of hepatocellular carcinoma.
10. A clinician orders the DCP oncoprotein test for a patient with suspected recurrence of hepatocellular carcinoma to monitor their disease progression.