How To Use CPT Code 84234

CPT code 84234 describes the procedure for a progesterone receptor assay, which is used to analyze the presence of progesterone receptors in tumor tissue, typically from the breast. 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 84234?

CPT 84234 can be used to describe the procedure for a progesterone receptor assay. This test is performed by a lab analyst on tissue from a tumor, usually from the breast, to determine the presence of progesterone receptors. The presence or absence of these receptors can influence treatment decisions for patients with invasive breast cancer or cancer recurrence.

2. Official Description

The official description of CPT code 84234 is: ‘Receptor assay; progesterone.’

3. Procedure

1. The lab analyst receives a tumor sample and freezes it.
2. A radioactively labeled compound, known as a ligand, is applied to the tumor sample. This ligand binds to estrogen receptors on the tumor.
3. After an incubation phase, the lab analyst measures the amount of radioactivity in the sample using a scintillation counter.

4. Qualifying circumstances

CPT 84234 is performed when a patient has been diagnosed with invasive breast cancer or has a recurrence of the cancer. The presence or absence of progesterone receptors in the tumor tissue can help determine the effectiveness of hormonal drug treatments. This test is typically ordered by clinicians to aid in treatment decisions for these patients.

5. When to use CPT code 84234

CPT code 84234 should be used when a progesterone receptor assay is performed on tumor tissue, specifically to analyze the presence of progesterone receptors. This code is not appropriate for immunohistochemical analysis of progesterone receptors; in such cases, an appropriate immunohistochemistry code should be used instead.

6. Documentation requirements

To support a claim for CPT 84234, the documentation should include:

• Patient’s diagnosis of invasive breast cancer or cancer recurrence
• Details of the progesterone receptor assay procedure performed
• Date of the procedure
• Results of the assay, indicating the presence or absence of progesterone receptors
• Signature of the lab analyst performing the procedure

7. Billing guidelines

When billing for CPT 84234, ensure that the procedure is performed by a lab analyst. There are no specific guidelines regarding reporting this code with other codes. However, it is important to note that if an immunohistochemical analysis for progesterone receptors is performed, CPT code 84234 should not be reported. Instead, an appropriate immunohistochemistry code should be used.

8. Historical information

CPT code 84234 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 lab analyst performs a progesterone receptor assay on tumor tissue from a patient with invasive breast cancer.
2. A clinician orders a progesterone receptor assay on a tumor sample to determine the presence of progesterone receptors in a patient with a recurrence of breast cancer.
3. A lab analyst conducts a progesterone receptor assay on tumor tissue to assist in treatment decisions for a patient with invasive breast cancer.
4. A patient diagnosed with invasive breast cancer undergoes a progesterone receptor assay to determine the effectiveness of hormonal drug treatments.
5. A lab analyst performs a progesterone receptor assay on tumor tissue from a patient with a reoccurrence of breast cancer to guide treatment decisions.
6. A clinician orders a progesterone receptor assay on a tumor sample to assess the presence of progesterone receptors in a patient with invasive breast cancer.
7. A lab analyst conducts a progesterone receptor assay on tumor tissue to aid in treatment decisions for a patient with a recurrence of breast cancer.
8. A patient with invasive breast cancer undergoes a progesterone receptor assay to determine the suitability of hormonal drug treatments.
9. A lab analyst performs a progesterone receptor assay on tumor tissue from a patient with a reoccurrence of breast cancer to assess the potential effectiveness of hormonal drug treatments.
10. A clinician orders a progesterone receptor assay on a tumor sample to analyze the presence of progesterone receptors in a patient with invasive breast cancer.