How To Use CPT Code 85280

CPT 85280 describes the clotting test performed by a lab analyst to determine the presence of factor XII, also known as Hageman 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 85280?

CPT 85280 is used to describe the clotting test performed by a lab analyst to assess the presence of factor XII in a patient’s serum. This test is ordered by clinicians to investigate the cause of a prolonged partial thromboplastin time (PTT) test and to diagnose coagulation factor XII deficiency.

2. Official Description

The official description of CPT code 85280 is: ‘Clotting; factor XII (Hageman).’ This code represents the laboratory analysis performed by a lab analyst to determine the presence of factor XII in a patient’s serum.

3. Procedure

1. The lab analyst performs all technical steps to assess the presence of factor XII in the patient’s serum.
2. The lab method may involve mixing the patient’s plasma with a factor XII deficient substrate and evaluating the results with a chromogenic assay.
3. Alternatively, the lab analyst may add a partial thromboplastin time reagent and calcium to trigger coagulation and optically measure clot formation.

4. Qualifying circumstances

CPT 85280 is ordered by clinicians to investigate the cause of a prolonged PTT test and to diagnose coagulation factor XII deficiency. It is not limited to testing for a specific condition but is used to assess the presence of factor XII in a patient’s serum.

5. When to use CPT code 85280

CPT code 85280 should be used when a clinician orders a clotting test to determine the presence of factor XII in a patient’s serum. It is appropriate when investigating the cause of a prolonged PTT test or diagnosing coagulation factor XII deficiency.

6. Documentation requirements

To support a claim for CPT 85280, the lab analyst must document the following information:

• Patient’s information and relevant medical history
• Details of the clotting test performed, including the method used
• Results of the clotting test
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 85280, ensure that the clotting test is performed by a lab analyst. It is important to follow the specific guidelines provided by the payer regarding the reporting of this code. Some payers may also separately reimburse for specimen collection using a code such as 36415 for venipuncture.

8. Historical information

CPT 85280 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 determine the presence of factor XII in a patient’s serum, as ordered by a clinician.
2. A patient with a prolonged PTT test undergoes a clotting test to investigate the cause, and the lab analyst assesses the presence of factor XII.
3. A clinician suspects coagulation factor XII deficiency in a patient and orders a clotting test to confirm the diagnosis.
4. A lab analyst mixes the patient’s plasma with a factor XII deficient substrate and evaluates the results using a chromogenic assay to determine the presence of factor XII.
5. The lab analyst adds a partial thromboplastin time reagent and calcium to the patient’s plasma, triggering coagulation, and optically measures clot formation to assess the presence of factor XII.
6. A clinician orders a clotting test to investigate the cause of abnormal bleeding in a patient, and the lab analyst performs the necessary analysis to assess the presence of factor XII.
7. A patient with a family history of coagulation disorders undergoes a clotting test to determine if they have coagulation factor XII deficiency.
8. A lab analyst evaluates the presence of factor XII in a patient’s serum to assist in the diagnosis of a bleeding disorder.
9. A clinician orders a clotting test to assess the patient’s coagulation profile, and the lab analyst performs the necessary analysis to determine the presence of factor XII.
10. A patient with unexplained bruising undergoes a clotting test to investigate the cause, and the lab analyst assesses the presence of factor XII.