How To Use CPT Code 84275

CPT 84275 describes the measurement of sialic acid, typically in patient blood, to evaluate for malignancies such as Hodgkin’s lymphoma, melanoma, and leukemia, as well as to monitor therapy for these conditions. 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 84275?

CPT 84275 is used to measure sialic acid levels in patient blood. Sialic acid is a component of the proteins and lipids that form cell membranes and is released by malignant cells. This test is commonly ordered by clinicians to evaluate patients for malignancies such as Hodgkin’s lymphoma, melanoma, and leukemia, as well as to monitor therapy for these conditions.

2. Official Description

The official description of CPT code 84275 is not available. However, it is important to note that this code should not be used for sickle hemoglobin testing, as there is a specific code (85660) for that purpose.

3. Procedure

1. The lab analyst performs the technical steps to mix the patient’s blood specimen with specific substances to measure sialic acid.
2. The test may use methods such as colorimetry, which measures the amount of color produced after a chemical reaction, providing a numerical result corresponding to the amount of sialic acid in the specimen.

4. Qualifying circumstances

CPT 84275 is typically ordered by clinicians to evaluate patients for malignancies such as Hodgkin’s lymphoma, melanoma, and leukemia. It may also be used to monitor therapy for these conditions. There are no specific qualifying circumstances mentioned for this code.

5. When to use CPT code 84275

CPT code 84275 should be used when measuring sialic acid levels in patient blood to evaluate for malignancies or monitor therapy for conditions such as Hodgkin’s lymphoma, melanoma, and leukemia. It should not be used for sickle hemoglobin testing, as there is a separate code (85660) for that purpose.

6. Documentation requirements

To support a claim for CPT 84275, the following documentation is typically required:

• Patient’s diagnosis or reason for ordering the test
• Details of the specific substances and methods used to measure sialic acid
• Date of the test
• Results of the test, including the numerical value of sialic acid levels
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 84275, ensure that the test is performed to measure sialic acid levels in patient blood. It is important to note that this code should not be reported for sickle hemoglobin testing. Some payers may separately reimburse for the collection of the blood specimen using a code such as 36415 (Collection of venous blood by venipuncture).

8. Historical information

CPT 84275 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 patient with suspected Hodgkin’s lymphoma undergoes a sialic acid test to aid in the diagnosis and staging of the disease.
2. A melanoma patient receives regular sialic acid tests to monitor the effectiveness of their treatment.
3. A leukemia patient undergoes a sialic acid test to assess their response to chemotherapy.
4. A clinician orders a sialic acid test for a patient with unexplained symptoms to rule out malignancies.
5. A patient with a history of Hodgkin’s lymphoma undergoes routine sialic acid tests as part of their follow-up care.
6. A melanoma patient receives a sialic acid test to evaluate the progression of their disease.
7. A clinician orders a sialic acid test for a patient with suspected leukemia to aid in the diagnosis.
8. A patient with a family history of malignancies undergoes a sialic acid test as a preventive measure.
9. A clinician orders a sialic acid test for a patient with unexplained weight loss and fatigue to evaluate for possible malignancies.
10. A patient undergoing therapy for Hodgkin’s lymphoma receives regular sialic acid tests to monitor their response to treatment.