How To Use CPT Code 84135

CPT 84135 describes the measurement of pregnanediol levels in a patient specimen, such as urine. 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 84135?

CPT 84135 can be used to measure the levels of pregnanediol in a patient specimen, typically urine. This test helps evaluate the component of the hormone progesterone, which is important for normal menstruation and fertility. The test is performed by a lab analyst using reagents and an instrument like a gas chromatograph to analyze the specimen.

2. Official Description

The official description of CPT code 84135 is: ‘Measurement of pregnanediol in a patient specimen (eg, urine).’

3. Procedure

1. The lab analyst receives a patient specimen, usually urine, for testing.
2. The analyst prepares the specimen by adding reagents to facilitate the desired change or reaction.
3. The specimen is then analyzed using an instrument, such as a gas chromatograph, which separates particles by size in a gaseous phase.
4. The instrument provides measurements of pregnanediol levels in the patient specimen.
5. The lab analyst interprets the results and reports them to the healthcare provider.

4. Qualifying circumstances

CPT 84135 is typically ordered by clinicians to monitor women during fertility treatment or to assess pregnant women for premature delivery. It can also help diagnose placental malfunction or preeclampsia, a condition characterized by high blood pressure during pregnancy. The test is not limited to specific conditions and can be used as needed based on clinical judgment.

5. When to use CPT code 84135

CPT code 84135 should be used when there is a clinical need to measure pregnanediol levels in a patient specimen, such as urine. It is important to ensure that the test is medically necessary and will provide valuable information for patient management.

6. Documentation requirements

To support a claim for CPT 84135, the healthcare provider must document the following information:

• Reason for ordering the test and its medical necessity
• Patient’s diagnosis or condition being evaluated
• Date and time of specimen collection
• Results of the test, including the measured pregnanediol levels
• Interpretation of the results and any relevant clinical implications
• Signature of the healthcare provider ordering the test

7. Billing guidelines

When billing for CPT 84135, ensure that the test is performed by a qualified lab analyst and that the results are accurately reported. It is important to follow the specific guidelines provided by the payer to ensure proper reimbursement. CPT code 84135 should not be reported with other codes unless there are specific circumstances that warrant additional codes.

8. Historical information

CPT 84135 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A clinician orders CPT 84135 to monitor a woman’s pregnanediol levels during fertility treatment.
2. A healthcare provider requests CPT 84135 to assess a pregnant patient for premature delivery.
3. A clinician utilizes CPT 84135 to help diagnose placental malfunction in a pregnant woman.
4. A healthcare provider orders CPT 84135 to evaluate a patient with suspected preeclampsia.
5. A clinician requests CPT 84135 to monitor a woman’s hormone levels during hormone replacement therapy.
6. A healthcare provider utilizes CPT 84135 to assess a patient’s hormone levels in the context of menstrual irregularities.
7. A clinician orders CPT 84135 to evaluate a patient with suspected hormonal imbalances.
8. A healthcare provider requests CPT 84135 to monitor a patient’s hormone levels during menopause.
9. A clinician utilizes CPT 84135 to assess a patient’s hormone levels in the context of fertility evaluation.
10. A healthcare provider orders CPT 84135 to monitor a patient’s hormone levels during treatment for polycystic ovary syndrome.