How To Use CPT Code 84235

CPT 84235 describes the evaluation of hormone receptor levels other than estrogen or progesterone in a patient specimen. 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 84235?

CPT 84235 can be used to evaluate the levels of hormone receptors other than estrogen or progesterone in a patient specimen, such as serum. This code is used when a lab analyst performs a test to measure the quantity of a specific hormone receptor, using methods like radioimmunoassay, which involves an antibody antigen reaction with a radioactive tag.

2. Official Description

The official description of CPT code 84235 is: ‘Receptor assay; endocrine, other than estrogen or progesterone (specify hormone).’ This code is used to measure the levels of hormone receptors other than estrogen or progesterone in a patient specimen.

3. Procedure

1. The lab analyst receives a patient specimen, such as serum, for testing.
2. The lab analyst selects the appropriate method, such as radioimmunoassay, to measure the levels of the specific hormone receptor.
3. The lab analyst performs the test by utilizing an antibody antigen reaction with a radioactive tag to quantify the tagged hormone receptor.
4. The lab analyst may use instruments like a gamma counter to measure the quantity of the hormone receptor in the patient specimen.
5. The lab analyst records the results of the test for further analysis and interpretation.

4. Qualifying circumstances

CPT 84235 is used when clinicians order a test to evaluate the levels of hormone receptors other than estrogen or progesterone in patients. This test can aid in the diagnosis or monitoring of patients with conditions related to abnormal hormone receptor status, such as certain forms of thyroid disease. It is important to note that this code should not be used for estrogen receptor or progesterone receptor assays for breast cancer patients, as those tests are excluded from the code definition.

5. When to use CPT code 84235

CPT code 84235 should be used when there is a clinical need to evaluate the levels of hormone receptors other than estrogen or progesterone in a patient specimen. It is appropriate to use this code when the test is performed to aid in the diagnosis or monitoring of patients with conditions related to abnormal hormone receptor status. However, it should not be used for estrogen receptor or progesterone receptor assays for breast cancer patients.

6. Documentation requirements

To support a claim for CPT code 84235, the documentation should include:

• Reason for ordering the test and its clinical significance
• Details of the patient specimen used for testing
• Method used for measuring the hormone receptor levels
• Results of the test, including the quantity of the hormone receptor
• Interpretation of the results, if applicable

7. Billing guidelines

When billing for CPT code 84235, ensure that the test is performed to evaluate hormone receptor levels other than estrogen or progesterone. It is important to note that some payers may separately reimburse for specimen collection using a different code, such as 36415 for venous blood collection by venipuncture. It is also essential to review payer-specific guidelines and policies for accurate billing and reimbursement.

8. Historical information

CPT code 84235 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 lab analyst performs a receptor assay to measure the levels of thyroid stimulating hormone receptor in a patient specimen.
2. A clinician orders a test to evaluate the levels of luteinizing hormone receptor in a patient with suspected reproductive system disorders.
3. A lab analyst performs a receptor assay to measure the levels of follicle-stimulating hormone receptor in a patient specimen for the diagnosis of certain fertility issues.
4. A patient with suspected adrenal gland disorders undergoes a receptor assay to evaluate the levels of adrenocorticotropic hormone receptor in their specimen.
5. A clinician orders a test to measure the levels of growth hormone receptor in a patient with growth-related concerns.
6. A lab analyst performs a receptor assay to evaluate the levels of parathyroid hormone receptor in a patient specimen for the diagnosis of parathyroid disorders.
7. A patient with suspected pituitary gland disorders undergoes a receptor assay to measure the levels of prolactin receptor in their specimen.
8. A clinician orders a test to evaluate the levels of thyroid hormone receptor in a patient with thyroid-related conditions.
9. A lab analyst performs a receptor assay to measure the levels of insulin receptor in a patient specimen for the diagnosis of insulin resistance.
10. A patient with suspected gonadal disorders undergoes a receptor assay to evaluate the levels of anti-Müllerian hormone receptor in their specimen.