How To Use CPT Code 85525

CPT 85525 describes the process of heparin neutralization performed by a lab analyst to remove any heparin present in a patient specimen. 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 85525?

CPT 85525 can be used to describe the laboratory procedure performed by a lab analyst to neutralize heparin in a patient specimen. This code is used when heparin contamination is suspected as the cause of a prolonged partial thromboplastin time (PTT) test or when coagulation studies are needed for patients on heparin therapy. The lab analyst adds a specific enzyme called heparinase to the patient plasma specimen, which degrades heparin and prevents it from functioning as an anticoagulant.

2. Official Description

The official description of CPT code 85525 is: ‘Heparin neutralization; lab analyst performs the technical lab steps to neutralize heparin by adding a specific enzyme (heparinase) to the patient plasma specimen and allowing it to incubate for a specific time period.’

3. Procedure

1. The lab analyst assesses the patient specimen for heparin contamination.
2. If heparin contamination is suspected, the lab analyst adds heparinase, a specific enzyme, to the patient plasma specimen.
3. The specimen is incubated for a specific time period to allow the heparinase to degrade the heparin.
4. After the incubation period, the lab analyst performs further testing or coagulation studies on the neutralized specimen.

4. Qualifying circumstances

CPT 85525 is performed when heparin contamination is suspected as the cause of a prolonged PTT test or when coagulation studies are needed for patients on heparin therapy. It is important to note that this procedure is performed by a lab analyst and not a healthcare professional.

5. When to use CPT code 85525

CPT code 85525 should be used when heparin contamination is suspected as the cause of a prolonged PTT test or when coagulation studies are needed for patients on heparin therapy. It is not appropriate to use this code for other purposes unrelated to heparin neutralization.

6. Documentation requirements

To support a claim for CPT 85525, the lab analyst must document the following information:

• Reason for performing the heparin neutralization procedure
• Specific enzyme used (heparinase)
• Date and time of the procedure
• Results of any additional testing or coagulation studies performed on the neutralized specimen

7. Billing guidelines

When billing for CPT 85525, ensure that the procedure is performed by a lab analyst and not a healthcare professional. It is important to note that some payers may separately reimburse for specimen collection using a code such as 36415 for venipuncture. Additionally, it is necessary to perform a PTT test following the 85525 procedure to complete the evaluation for suspected heparin contamination.

8. Historical information

CPT 85525 was added to the Current Procedural Terminology system on January 1, 1993. There have been no updates to the code since its addition.

9. Examples

1. A lab analyst performing heparin neutralization on a patient specimen to investigate the cause of a prolonged PTT test.
2. A lab analyst adding heparinase to a patient plasma specimen to remove heparin before conducting coagulation studies for a patient on heparin therapy.
3. A lab analyst incubating a patient specimen with heparinase to degrade heparin and prevent it from interfering with further testing.
4. A lab analyst performing heparin neutralization on samples drawn through heparinized lines for neonatal patients.
5. A lab analyst conducting heparin neutralization to ensure accurate coagulation study results for a patient with suspected heparin contamination.
6. A lab analyst using heparinase to neutralize heparin in a patient specimen and perform necessary coagulation studies for a patient on anticoagulant therapy.
7. A lab analyst performing heparin neutralization to investigate the cause of prolonged PTT test results in a patient.
8. A lab analyst adding heparinase to a patient plasma specimen to remove heparin and obtain accurate coagulation study results.
9. A lab analyst incubating a patient specimen with heparinase to degrade heparin and prevent it from interfering with further testing for a patient on heparin therapy.
10. A lab analyst performing heparin neutralization to remove heparin contamination and ensure accurate coagulation study results for a patient.