How To Use CPT Code 84431

CPT 84431 describes the measurement of thromboxane metabolites, including thromboxane if performed, in patient urine. 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 84431?

CPT 84431 can be used to measure thromboxane metabolites, including thromboxane if performed, in patient urine. This code is used when the lab analyst performs specific lab steps to mix patient urine with substances to measure these metabolites. Thromboxane is an enzyme found in platelets that assists in clot formation and constricts blood vessels. The metabolites measured are thromboxane A2 and thromboxane B2.

2. Official Description

The official description of CPT code 84431 is: ‘Thromboxane metabolite(s), including thromboxane if performed, urine (For concurrent urine creatinine determination, use 84431 in conjunction with 82570)’

3. Procedure

1. The lab analyst performs specific lab steps to mix patient urine with substances to measure thromboxane metabolites.
2. The lab may use methods such as mass spectrometry to identify the resulting elements or molecules by their masses or characteristic fragmentation patterns.
3. The test may involve the measurement of thromboxane A2 and thromboxane B2.
4. If the analyst also performs a urine creatinine determination, CPT code 82570 should be used in conjunction with 84431.

4. Qualifying circumstances

CPT 84431 is typically ordered by clinicians to evaluate patients for increased risk of blood clots or stroke, as elevated thromboxane levels may indicate such risks. It can also be used to assess the effectiveness of aspirin therapy in preventing blood clots or strokes, as aspirin inhibits the production of thromboxane. There are no specific qualifying circumstances mentioned for this code.

5. When to use CPT code 84431

CPT code 84431 should be used when the lab analyst performs the test to measure thromboxane metabolites, including thromboxane if performed, in patient urine. It is appropriate to use this code when evaluating patients for increased risk of blood clots or stroke or to assess the effectiveness of aspirin therapy.

6. Documentation requirements

To support a claim for CPT 84431, the documentation should include:

• Reason for ordering the test, such as evaluating risk of blood clots or stroke or assessing the effectiveness of aspirin therapy
• Specific lab steps performed by the analyst to measure thromboxane metabolites
• Date and time of the test
• Results of the test, including the measurement of thromboxane A2 and thromboxane B2
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 84431, ensure that the lab analyst performs the test to measure thromboxane metabolites in patient urine. If the analyst also performs a urine creatinine determination, use CPT code 82570 in conjunction with 84431. There are no specific guidelines mentioned regarding reporting this code with other codes.

8. Historical information

CPT 84431 was added to the Current Procedural Terminology system on January 1, 2010. There have been no updates to the code since its addition.

9. Examples

1. A clinician orders CPT 84431 to evaluate a patient’s risk of blood clots or stroke.
2. A patient on aspirin therapy undergoes CPT 84431 to assess the effectiveness of the treatment.
3. A lab analyst performs CPT 84431 to measure thromboxane metabolites in a patient with a suspected clotting disorder.
4. CPT 84431 is used to evaluate a patient with a history of strokes for ongoing monitoring of thromboxane levels.
5. A clinician orders CPT 84431 to assess the risk of blood clots in a patient with a family history of clotting disorders.
6. A patient with a recent heart attack undergoes CPT 84431 to evaluate their risk of future cardiovascular events.
7. CPT 84431 is used to assess the effectiveness of aspirin therapy in a patient with a history of blood clots.
8. A lab analyst performs CPT 84431 to measure thromboxane metabolites in a patient with unexplained bleeding episodes.
9. A clinician orders CPT 84431 to evaluate a patient with recurrent strokes for potential underlying clotting disorders.
10. CPT 84431 is used to monitor thromboxane levels in a patient undergoing anticoagulant therapy.