How To Use CPT Code 84702

CPT 84702 is a code used for the quantitative measurement of human chorionic gonadotropin (hCG) in blood samples, primarily for confirming or monitoring pregnancy and diagnosing certain tumors. This article will cover the description, procedure, qualifying circumstances, billing guidelines, documentation requirements, historical information, similar codes, and examples of CPT 84702.

1. What is CPT 84702?

CPT 84702 is a code used by medical professionals to bill for the quantitative measurement of human chorionic gonadotropin (hCG) in blood samples. This test is primarily used to confirm or monitor pregnancy, diagnose certain tumors of the testes or ovaries, and determine the age of the fetus. The code is specific to the quantitative measurement of hCG and should not be used for qualitative tests or urine pregnancy tests.

2. 84702 CPT code description

The official description of CPT code 84702 is: “Gonadotropin, chorionic (hCG); quantitative.”

3. Procedure

The procedure for CPT 84702 involves the following steps:

1. Collection of a blood sample from the patient.
2. Transportation of the blood sample to the laboratory.
3. Preparation of the blood sample for analysis, including separation of serum or plasma from the blood cells.
4. Measurement of the hCG levels in the blood sample using an immunoassay technique.
5. Interpretation of the test results by a qualified professional, such as a laboratory technician or physician.
6. Documentation of the test results and communication of the findings to the ordering physician or other healthcare provider.

4. Qualifying circumstances

Patients who are eligible to receive CPT code 84702 services include those who:

• Are suspected of being pregnant, based on clinical symptoms or missed menstrual periods.
• Have a confirmed pregnancy and require monitoring of hCG levels for various reasons, such as assessing the risk of miscarriage or ectopic pregnancy.
• Are undergoing fertility treatments and need to monitor hCG levels to determine the success of the treatment.
• Are suspected of having certain tumors of the testes or ovaries that produce hCG, such as choriocarcinoma or germ cell tumors.
• Require hCG testing for other medical reasons, as determined by a healthcare provider.

5. When to use CPT code 84702

It is appropriate to bill the 84702 CPT code when a healthcare provider orders a quantitative hCG test for one of the qualifying circumstances listed above. The test should be performed by a qualified laboratory technician or other medical professional and the results should be documented and communicated to the ordering provider.

6. Documentation requirements

To support a claim for CPT 84702, the following information should be documented:

• The patient’s demographic information, including name, date of birth, and medical record number.
• The date and time of the blood sample collection.
• The indication for the test, such as suspected pregnancy, monitoring of an existing pregnancy, or evaluation of a potential tumor.
• The specific type of immunoassay used to measure hCG levels.
• The test results, including the quantitative hCG level and the reference range for comparison.
• The interpretation of the test results by a qualified professional.
• Any relevant clinical notes or observations related to the test.

7. Billing guidelines

When billing for CPT code 84702, it is important to follow the appropriate guidelines and rules. Some tips for billing this code include:

• Ensure that the test is medically necessary and meets the qualifying circumstances for the patient.
• Document all required information to support the claim, as outlined in the documentation requirements section.
• Use the correct CPT code for the specific type of hCG test performed (quantitative vs. qualitative).
• Be aware of any payer-specific requirements or guidelines for billing CPT 84702, as these may vary between insurance companies.

8. Historical information

CPT 84702 was added to the Current Procedural Terminology system on January 1, 1990. There have been no major updates to the code since its addition.

9. Similar codes to CPT 84702

There are several other codes related to hCG testing that differentiate from CPT 84702. These include:

• CPT 84703: This code is used for qualitative hCG testing, which provides a simple positive or negative result for the presence of hCG, rather than a specific level.
• CPT 81025: This code is used for urine pregnancy tests, which are performed by visual color comparison and do not involve a blood sample or quantitative measurement.
• CPT 83001: This code is used for the measurement of follicle-stimulating hormone (FSH) levels, which can be related to fertility and reproductive health but are not specific to hCG.
• CPT 83002: This code is used for the measurement of luteinizing hormone (LH) levels, another hormone related to fertility and reproductive health but not specific to hCG.
• CPT 84144: This code is used for the measurement of progesterone levels, a hormone that can be used to monitor pregnancy but is not specific to hCG.

10. Examples

Here are 10 detailed examples of CPT code 84702 procedures:

1. A woman with a missed menstrual period and symptoms of pregnancy has a blood sample drawn for a quantitative hCG test to confirm the pregnancy.
2. A pregnant woman with a history of miscarriage has a quantitative hCG test performed to monitor the progress of her pregnancy and assess the risk of another miscarriage.
3. A woman undergoing in vitro fertilization (IVF) has a quantitative hCG test performed to determine if the treatment has resulted in a successful pregnancy.
4. A man with a testicular mass has a quantitative hCG test performed to evaluate the possibility of a germ cell tumor.
5. A woman with a history of ectopic pregnancy has a quantitative hCG test performed to monitor her current pregnancy and rule out another ectopic pregnancy.
6. A pregnant woman with abnormal ultrasound findings has a quantitative hCG test performed to help determine the age of the fetus and assess the risk of complications.
7. A woman with a suspected molar pregnancy has a quantitative hCG test performed to confirm the diagnosis and monitor the effectiveness of treatment.
8. A man with a history of testicular cancer has a quantitative hCG test performed as part of his routine follow-up care to monitor for recurrence.
9. A woman with irregular menstrual periods and symptoms of polycystic ovary syndrome (PCOS) has a quantitative hCG test performed to rule out pregnancy before starting treatment for PCOS.
10. A pregnant woman with a family history of genetic disorders has a quantitative hCG test performed as part of a prenatal screening panel to assess the risk of chromosomal abnormalities in the fetus.