How To Use CPT Code 84228

CPT 84228 describes the measurement of quinine levels in a patient specimen, such as serum or plasma. 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 84228?

CPT 84228 can be used to measure the levels of quinine in a patient specimen, such as serum or plasma. This code is used when a lab analyst performs a test to evaluate the concentration of quinine using a method called high performance liquid chromatography (HPLC) with mass spectrometry. Quinine is a common antimalarial alkaloid drug, and this test is often ordered for therapeutic drug monitoring in patients taking quinine or to test for possible quinine poisoning.

2. Official Description

The official description of CPT code 84228 is: ‘Measurement of quinine, serum or plasma, by mass spectrometry.’

3. Procedure

1. The lab analyst receives a patient specimen, such as serum or plasma, for testing.
2. The lab analyst performs a test using high performance liquid chromatography (HPLC) with mass spectrometry to separate and quantify the quinine in the specimen.
3. The HPLC separates the constituents of the specimen as they travel in a liquid called the mobile phase at different speeds up a column of a substrate called the stationary phase.
4. Once isolated by the HPLC, the mass spectrometer quantifies the quinine by mass.
5. The lab analyst records the results of the test and prepares a report for the healthcare provider.

4. Qualifying circumstances

CPT 84228 is used when a healthcare provider orders a test to measure the levels of quinine in a patient specimen. This test may be ordered for therapeutic drug monitoring in patients taking quinine or to test for possible quinine poisoning. Quinine poisoning can cause symptoms such as unusual bleeding, rapid irregular heartbeat, and liver and kidney damage.

5. When to use CPT code 84228

CPT code 84228 should be used when a healthcare provider orders a test to measure the levels of quinine in a patient specimen, such as serum or plasma. This code is appropriate for therapeutic drug monitoring in patients taking quinine or to test for possible quinine poisoning. It should not be used for testing unrelated to quinine levels.

6. Documentation requirements

To support a claim for CPT code 84228, the healthcare provider must document the following information:

• Reason for ordering the test, such as therapeutic drug monitoring or suspicion of quinine poisoning
• Date and time of specimen collection
• Results of the test, including the measured quinine levels
• Signature of the healthcare provider ordering the test

7. Billing guidelines

When billing for CPT code 84228, ensure that the test is performed by a lab analyst using high performance liquid chromatography (HPLC) with mass spectrometry to measure quinine levels in a patient specimen. This code should not be reported with other codes unless specifically instructed by the payer. It is important to follow any specific billing guidelines provided by the payer to ensure accurate reimbursement.

8. Historical information

CPT code 84228 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A healthcare provider orders a test to measure the levels of quinine in a patient’s serum to monitor the effectiveness of quinine therapy for malaria treatment.
2. A patient presents with symptoms of quinine poisoning, and a healthcare provider orders a test to measure the levels of quinine in the patient’s plasma to confirm the diagnosis.
3. A healthcare provider suspects that a patient is not taking their prescribed quinine medication as directed and orders a test to measure the levels of quinine in the patient’s serum for therapeutic drug monitoring.
4. A patient with a history of quinine allergy is admitted to the hospital with symptoms of an allergic reaction, and a healthcare provider orders a test to measure the levels of quinine in the patient’s plasma to confirm the allergy.
5. A healthcare provider orders a test to measure the levels of quinine in a patient’s serum to assess their compliance with quinine therapy for malaria prevention.
6. A patient presents with symptoms of quinine overdose, and a healthcare provider orders a test to measure the levels of quinine in the patient’s plasma to determine the severity of the overdose.
7. A healthcare provider suspects that a patient is experiencing quinine toxicity and orders a test to measure the levels of quinine in the patient’s serum to guide treatment decisions.
8. A patient with a history of quinine use is scheduled for surgery, and a healthcare provider orders a test to measure the levels of quinine in the patient’s plasma to ensure safe anesthesia administration.
9. A healthcare provider orders a test to measure the levels of quinine in a patient’s serum to assess their compliance with quinine therapy for leg cramps.
10. A patient presents with symptoms of quinine side effects, and a healthcare provider orders a test to measure the levels of quinine in the patient’s plasma to determine the cause of the symptoms.