How To Use CPT Code 85397

CPT 85397 describes the functional activity test for coagulation and fibrinolysis, specifically for a biochemical compound that does not have a separate, specific procedure code. 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 85397?

CPT 85397 can be used to describe a functional activity test for coagulation and fibrinolysis related to a specific biochemical compound that does not have a separate, specific procedure code. This code is used when the lab analyst performs a test to evaluate the functional activity of a compound involved in clot formation or breakdown.

2. Official Description

The official description of CPT code 85397 is: ‘Coagulation and fibrinolysis, functional activity, not otherwise specified (eg, ADAMTS-13), each analyte.’

3. Procedure

1. The lab analyst performs a functional activity test for a specific biochemical compound related to coagulation or fibrinolysis.
2. The test assesses the functional activity of the compound involved in clot formation or breakdown.
3. The specific biochemical compound being tested does not have a separate, specific procedure code.
4. The test may be ordered by clinicians to evaluate functional problems with coagulation and fibrinolysis related to specific compounds not listed in other codes.
5. The test results help in the diagnosis and management of conditions such as thrombotic thrombocytopenic purpura (TTP).

4. Qualifying circumstances

CPT 85397 is used when there is a need to evaluate the functional activity of a specific biochemical compound related to coagulation or fibrinolysis that does not have a separate, specific procedure code. This test may be ordered by clinicians to assess functional problems with coagulation and fibrinolysis for specific compounds not listed in other codes. For example, the test for ADAMTS-13 deficiency can aid in the diagnosis of thrombotic thrombocytopenic purpura (TTP).

5. When to use CPT code 85397

CPT code 85397 should be used when there is a need to evaluate the functional activity of a specific biochemical compound related to coagulation or fibrinolysis that does not have a separate, specific procedure code. This code is used when there is no other more specific code available for the analyte being tested.

6. Documentation requirements

To support a claim for CPT 85397, the documentation should include:

• The specific biochemical compound being tested
• The reason for ordering the test and the clinical indication
• The date and time of the test
• The test results and interpretation
• The signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 85397, ensure that the test is performed for a specific biochemical compound related to coagulation or fibrinolysis that does not have a separate, specific procedure code. Report a single unit of CPT 85397 for each unique, unlisted analyte tested. It is important to note that this code should only be used if there is no other more specific code available for the analyte being tested.

8. Historical information

CPT 85397 was added to the Current Procedural Terminology system on January 1, 2009. There have been no updates to the code since its addition.

9. Examples

1. A lab analyst performs a functional activity test for ADAMTS-13, a specific biochemical compound involved in coagulation and fibrinolysis.
2. A functional activity test is conducted for a unique, unlisted analyte related to coagulation and fibrinolysis.
3. The lab performs a test to evaluate the functional activity of a specific biochemical compound not covered by other codes.
4. A functional activity test is performed to assess the clot formation or breakdown for a specific biochemical compound.
5. A lab analyst conducts a test to evaluate the functional activity of a compound involved in coagulation and fibrinolysis, providing valuable information for the diagnosis and management of a patient’s condition.
6. A functional activity test is performed to assess the functional problems with coagulation and fibrinolysis related to a specific biochemical compound.
7. The lab analyst performs a test to evaluate the functional activity of a unique analyte involved in clot formation or breakdown.
8. A functional activity test is conducted for a specific biochemical compound not covered by other codes, aiding in the diagnosis and management of a patient’s condition.
9. The lab performs a test to assess the functional activity of a compound related to coagulation and fibrinolysis, providing crucial information for the patient’s treatment plan.
10. A functional activity test is performed to evaluate the functional problems with coagulation and fibrinolysis for a specific biochemical compound, assisting in the diagnosis and monitoring of the patient’s condition.