How To Use CPT Code 84126

CPT 84126 describes the quantitative evaluation of various porphyrin compounds in a patient’s fecal 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 84126?

CPT 84126 can be used to describe the quantitative assessment of different porphyrin compounds in a patient’s fecal specimen. This test helps in distinguishing between various forms of porphyria, which are inherited disorders involving enzyme defects that prevent the body from converting porphyrins into heme. The accumulation of different porphyrins in feces is characteristic of different types of porphyria, such as acute intermittent porphyria (AIP), hereditary coproporphyria (HCP), variegate porphyria (VP), porphyria cutanea tarda (PCT), erythropoietic protoporphyria (EPP), X-linked dominant protoporphyria (XLDPP), and congenital erythropoietic porphyria (CEP).

2. Official Description

The official description of CPT code 84126 is: ‘Porphyrins, feces, quantitative.’

3. Procedure

1. The lab analyst performs a test on a patient’s fecal specimen to evaluate the level of various porphyrin compounds.
2. The lab analyst may add reagents to the specimen and use methods such as high-pressure liquid chromatography (HPLC) to separate chemicals of different sizes.
3. The test results provide quantitative information about the levels of different porphyrins in the fecal specimen.

4. Qualifying circumstances

CPT 84126 is ordered by clinicians to help distinguish between different forms of porphyria. It is not limited to testing for a specific condition but is used to assess the levels of various porphyrins in feces. This test is particularly useful in diagnosing porphyrias such as PCT, HCP, VP, CEP, and XLDPP. These porphyrias may present with symptoms such as acute abdominal pain, nausea and vomiting, extremity pain, sun sensitivity, and dark urine.

5. When to use CPT code 84126

CPT code 84126 should be used when a quantitative assessment of various porphyrin compounds in a patient’s fecal specimen is required. It helps in distinguishing between different types of porphyria based on the accumulation of specific porphyrins in feces. This code is appropriate when the test is performed to aid in the diagnosis of porphyrias and is not limited to a specific condition or symptom.

6. Documentation requirements

To support a claim for CPT 84126, the documentation should include:

• Indication for the test and the suspected porphyria type
• Details of the test performed, including the use of reagents and the method employed (e.g., HPLC)
• Quantitative results of the various porphyrin compounds in the fecal specimen

7. Billing guidelines

When billing for CPT 84126, ensure that the test is performed to evaluate the quantitative levels of porphyrin compounds in a patient’s fecal specimen. There are no specific guidelines regarding reporting this code with other codes. However, it is important to follow any payer-specific requirements and provide appropriate documentation to support the medical necessity of the test.

8. Historical information

CPT 84126 was added to the Current Procedural Terminology system on January 1, 1990. The code description was changed on January 1, 2015, to specify that the test is quantitative.

9. Examples

1. A patient presents with symptoms of acute abdominal pain, sun sensitivity, and dark urine. The clinician orders CPT 84126 to assess the quantitative levels of porphyrins in the patient’s fecal specimen and diagnose the specific type of porphyria.
2. A patient with a family history of porphyria undergoes CPT 84126 to determine if they have inherited any abnormal porphyrin levels in their feces, indicating a potential risk for developing porphyria.
3. A patient with suspected PCT undergoes CPT 84126 to confirm the diagnosis by assessing the accumulation of specific porphyrins in their fecal specimen.
4. A patient with symptoms of extremity pain and sun sensitivity undergoes CPT 84126 to evaluate the levels of porphyrins in their feces and aid in the diagnosis of VP.
5. A patient with a known diagnosis of XLDPP undergoes CPT 84126 to monitor the quantitative levels of porphyrins in their fecal specimen and assess the effectiveness of treatment.