How To Use CPT Code 84145

CPT 84145 describes the measurement of procalcitonin (PCT) levels in a patient specimen, such as serum. 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 84145?

CPT 84145 can be used to measure the levels of procalcitonin (PCT) in a patient specimen, typically serum. This code is used when a lab analyst performs a test to evaluate the level of PCT present in the specimen. The test may involve using procedures such as an immunoassay to form an antigen-antibody complex and measure fluorescent energy emissions to quantify the level of PCT.

2. Official Description

The official description of CPT code 84145 is: ‘Measurement of procalcitonin (PCT) in a patient specimen.’

3. Procedure

1. The lab analyst collects a patient specimen, such as serum, for testing.
2. The lab analyst performs a test to measure the levels of procalcitonin (PCT) in the specimen.
3. The test may involve using procedures such as an immunoassay to form an antigen-antibody complex and measure fluorescent energy emissions.
4. The lab analyst quantifies the level of PCT present in the specimen.

4. Qualifying circumstances

CPT 84145 is typically ordered by clinicians to help diagnose or evaluate the risk of suspected bacterial infections in certain clinical situations. Elevated PCT levels are associated with inflammation caused by systemic or severe bacterial infections. This test may be used to diagnose bacterial blood infections, kidney involvement in urinary tract infections, bacterial versus viral meningitis or pneumonia, and to assess the risk of septic shock. It can also be used to monitor the effectiveness of antibacterial treatment.

5. When to use CPT code 84145

CPT code 84145 should be used when a clinician orders a test to measure the levels of procalcitonin (PCT) in a patient specimen, such as serum. It is typically used in situations where there is a suspicion of bacterial infection and the clinician wants to assess the risk or monitor the effectiveness of treatment. This code should not be used for testing related to specific conditions or diseases.

6. Documentation requirements

To support a claim for CPT 84145, the documentation should include:

• Reason for ordering the test, such as suspected bacterial infection
• Details of the patient specimen collected for testing
• Description of the test performed to measure PCT levels
• Quantification of the PCT level in the specimen

7. Billing guidelines

When billing for CPT 84145, ensure that the test is performed by a lab analyst on a patient specimen, such as serum. It is important to follow the specific guidelines provided by the payer regarding the billing of this code. It is also important to note that some payers may separately reimburse for the collection of the specimen using a different code.

8. Historical information

CPT 84145 was added to the Current Procedural Terminology system on January 1, 2010. There have been no updates to the code since its addition.

9. Examples

1. A clinician orders a procalcitonin (PCT) test to assess the risk of bacterial blood infection in a patient with a high fever and other symptoms of sepsis.
2. A clinician orders a procalcitonin (PCT) test to differentiate between bacterial and viral meningitis in a patient with severe headache and neck stiffness.
3. A clinician orders a procalcitonin (PCT) test to monitor the effectiveness of antibacterial treatment in a patient with a urinary tract infection and kidney involvement.
4. A clinician orders a procalcitonin (PCT) test to assess the risk of septic shock in a patient with a severe bacterial infection.
5. A clinician orders a procalcitonin (PCT) test to evaluate the risk of bacterial pneumonia in a patient with respiratory symptoms and a history of chronic lung disease.
6. A clinician orders a procalcitonin (PCT) test to monitor the effectiveness of antibacterial treatment in a patient with a severe bacterial infection.
7. A clinician orders a procalcitonin (PCT) test to assess the risk of bacterial blood infection in a patient with a compromised immune system.
8. A clinician orders a procalcitonin (PCT) test to differentiate between bacterial and viral pneumonia in a patient with respiratory symptoms and a history of recent travel.
9. A clinician orders a procalcitonin (PCT) test to assess the risk of septic shock in a patient with a severe bacterial infection and signs of organ dysfunction.
10. A clinician orders a procalcitonin (PCT) test to monitor the effectiveness of antibacterial treatment in a patient with a urinary tract infection and recurrent episodes of infection.