How To Use CPT Code 84220

CPT 84220 describes the measurement of pyruvate kinase levels in a patient specimen, typically blood. 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 84220?

CPT 84220 can be used to measure the levels of pyruvate kinase in a patient specimen, such as blood. Pyruvate kinase is an enzyme involved in glucose metabolism in the blood. The test is performed by a lab analyst using a method like an enzyme reaction with kinetic spectrophotometry. By hemolyzing red blood cells and mixing the specimen with specific enzymes, the lab analyst can measure the rate of decrease of absorbance, which correlates with pyruvate kinase levels in the specimen.

2. Official Description

The official description of CPT code 84220 is: ‘Measurement of pyruvate kinase, an enzyme involved in glucose metabolism, in a patient specimen.’

3. Procedure

1. The lab analyst receives a patient specimen, typically blood, for pyruvate kinase measurement.
2. The lab analyst hemolyzes the red blood cells in the specimen and mixes it with specific enzymes.
3. The lab analyst uses a spectrophotometer to measure the rate of decrease of absorbance, which correlates with pyruvate kinase levels in the specimen.
4. The results are recorded and reported to the healthcare provider for further interpretation and diagnosis.

4. Qualifying circumstances

CPT 84220 is typically ordered by clinicians to help evaluate pyruvate kinase deficiency, a rare genetic disorder that causes nonspherocytic hemolytic anemia. This disorder is characterized by red blood cells with a nonspherical shape that rupture easily. Patients with symptoms such as anemia, enlarged spleen, and jaundice may undergo this test to aid in the diagnosis of pyruvate kinase deficiency.

5. When to use CPT code 84220

CPT code 84220 should be used when a healthcare provider orders the measurement of pyruvate kinase levels in a patient specimen, typically blood. It is appropriate to bill this code when the test is performed to evaluate pyruvate kinase deficiency or other conditions related to glucose metabolism. However, it should not be used for testing unrelated to pyruvate kinase levels.

6. Documentation requirements

To support a claim for CPT code 84220, the healthcare provider must document the following information:

• Reason for ordering the test, such as suspected pyruvate kinase deficiency
• Date and time of specimen collection
• Method used for pyruvate kinase measurement
• Results of the test
• Interpretation of the results and any additional actions taken
• Signature of the healthcare provider ordering the test

7. Billing guidelines

When billing for CPT code 84220, ensure that the test is performed to measure pyruvate kinase levels in a patient specimen. It is important to follow the specific guidelines provided by the payer regarding documentation and coding requirements. Some payers may also separately reimburse for specimen collection using a code such as 36415, Collection of venous blood by venipuncture.

8. Historical information

CPT code 84220 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 patient with symptoms of anemia, enlarged spleen, and jaundice undergoes a pyruvate kinase measurement to evaluate for pyruvate kinase deficiency.
2. A healthcare provider orders a pyruvate kinase test to assess glucose metabolism in a patient with suspected metabolic disorders.
3. A patient with a family history of pyruvate kinase deficiency undergoes a pyruvate kinase measurement as a precautionary measure.
4. A healthcare provider orders a pyruvate kinase test to monitor the effectiveness of treatment for a patient with known pyruvate kinase deficiency.
5. A patient with unexplained symptoms undergoes a pyruvate kinase measurement as part of a comprehensive diagnostic workup.