How To Use CPT Code 85597

CPT 85597 describes the evaluation of clotting time after adding phospholipids from platelet membranes to a patient’s blood 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 85597?

CPT 85597 can be used to evaluate the clotting time of a patient’s blood specimen after adding phospholipids from platelet membranes. This test helps detect the presence of antiphospholipid antibodies in the blood, which can interfere with the blood clotting process and increase the risk of blood clot formation in arteries and veins.

2. Official Description

The official description of CPT code 85597 is: ‘Phospholipid neutralization; platelet.’

3. Procedure

1. The lab analyst performs the technical steps to evaluate the clotting time of the patient’s blood specimen.
2. A reagent containing phospholipids from platelet membranes is added to the blood specimen.
3. The lab analyst measures the time it takes for the blood specimen to clot after the addition of the reagent.
4. The test results help in the detection of antiphospholipid antibodies in the blood.

4. Qualifying circumstances

CPT 85597 may be ordered for patients with unexplained repeat miscarriage, suspected thrombosis, or prolonged partial thromboplastin time test. It aids in the diagnosis of disorders that cause increased blood coagulation due to the presence of antiphospholipid antibodies targeting specific compounds in platelet cell membranes.

5. When to use CPT code 85597

CPT code 85597 should be used when evaluating the clotting time of a patient’s blood specimen after adding phospholipids from platelet membranes. It is not limited to testing for a specific condition but can aid in the diagnosis of disorders related to antiphospholipid antibodies.

6. Documentation requirements

To support a claim for CPT 85597, the documentation should include:

• Reason for ordering the test, such as unexplained repeat miscarriage or suspected thrombosis
• Details of the reagent used, specifically mentioning the addition of phospholipids from platelet membranes
• Date and time of the test
• Test results indicating the clotting time of the blood specimen

7. Billing guidelines

When billing for CPT 85597, ensure that the test is performed by a qualified lab analyst and that the necessary reagent is added to the blood specimen. It is important to distinguish between CPT codes 85597 and 85598 based on the reagent used before recording the clotting time. Additional tips for billing may include separate reporting for specimen collection using a venipuncture code.

8. Historical information

CPT 85597 was added to the Current Procedural Terminology system on January 1, 1993. The code was later changed on January 1, 2011, to specify platelet neutralization.

9. Examples

1. A patient with unexplained repeat miscarriage undergoes CPT 85597 to evaluate the presence of antiphospholipid antibodies in their blood.
2. A suspected thrombosis case requires CPT 85597 to aid in the diagnosis of a disorder causing increased blood coagulation.
3. A patient with a prolonged partial thromboplastin time test undergoes CPT 85597 to detect the presence of antiphospholipid antibodies.
4. CPT 85597 is performed on a patient with suspected antiphospholipid syndrome to evaluate their blood clotting time.
5. A patient with lupus anticoagulant undergoes CPT 85597 to monitor their blood clotting process.
6. CPT 85597 is performed on a patient with beta–2–glycoprotein antibody to assess their blood clotting risk.
7. A patient with cardiolipin antibody undergoes CPT 85597 to evaluate their blood clotting function.
8. CPT 85597 is performed on a patient with suspected arterial or venous thrombosis to aid in the diagnosis.
9. A patient with a history of blood clot formation undergoes CPT 85597 to monitor their antiphospholipid antibody levels.
10. CPT 85597 is performed on a patient with a prolonged prothrombin time test to assess their blood clotting function.