How To Use CPT Code 85260

CPT 85260 describes the clotting test performed by a lab analyst to determine the presence of factor X, also known as Stuart-Prower factor, in a patient’s serum. 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 85260?

CPT 85260 can be used to describe the clotting test performed by a lab analyst to assess the presence of factor X, also known as Stuart-Prower factor, in a patient’s serum. This code is used when the lab analyst performs all technical steps to evaluate the results using a standardized method, such as a chromogenic assay or prothrombin time reagent.

2. Official Description

The official description of CPT code 85260 is: ‘Clotting; factor X (Stuart-Prower).’ This code represents the lab analyst’s responsibility to assess the presence of factor X in the patient’s serum using various technical steps and methods.

3. Procedure

1. The lab analyst performs a clotting test to determine the presence of factor X in the patient’s serum.
2. The specific method used may involve mixing the patient’s plasma with a factor X deficient substrate and evaluating the results with a chromogenic assay or triggering coagulation with a prothrombin time reagent and measuring clot formation.
3. The lab analyst performs all technical steps required to assess the presence of factor X in the patient’s serum.

4. Qualifying circumstances

CPT 85260 is ordered by clinicians to investigate the cause of a prolonged partial thromboplastin time (PTT) or prothrombin time (PT) test. It is also used to diagnose coagulation factor X deficiency, which can be acquired due to conditions such as liver disease or vitamin K deficiency.

5. When to use CPT code 85260

CPT code 85260 should be used when a clotting test is performed to assess the presence of factor X in a patient’s serum. It is appropriate when investigating prolonged PTT or PT tests or diagnosing coagulation factor X deficiency.

6. Documentation requirements

To support a claim for CPT 85260, documentation should include:

• Reason for ordering the test, such as prolonged PTT or PT tests
• Specific method used to assess the presence of factor X
• Date and time of the test
• Results of the test
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 85260, ensure that the clotting test is performed by a lab analyst. It is important to follow the specific guidelines provided by payers for collecting the specimen, such as using a separate code for venipuncture.

8. Historical information

CPT 85260 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 clotting test to assess the presence of factor X in a patient’s serum to investigate the cause of a prolonged PTT test.
2. A clinician orders a clotting test to diagnose coagulation factor X deficiency in a patient with liver disease.
3. A lab analyst evaluates the results of a clotting test using a chromogenic assay to determine the presence of factor X in a patient’s serum.
4. A patient undergoes a clotting test to investigate the cause of a prolonged PT test, and the lab analyst performs all technical steps to assess the presence of factor X.
5. A clinician orders a clotting test to diagnose coagulation factor X deficiency in a patient with vitamin K deficiency, and the lab analyst performs the necessary technical steps to evaluate the results.