CPT® Code 0085T

Code deleted, see 84999, 22857

Official Description

Breath test for heart transplant rejection

Common Language Description

A breath test for heart transplant rejection, designated by CPT® Code 0085T, serves as a diagnostic tool to assist in the detection of grade 3 heart transplant rejection in patients who have undergone an allograft heart transplant within the past year. This test is utilized as an adjunct to the more invasive procedure of endomyocardial biopsy, which is the standard method for assessing transplant rejection. The breath test specifically measures the presence of methylated alkanes in the patient's exhaled breath. An increase in these methylated alkanes can indicate oxidative stress and the breakdown of membrane polyunsaturated fatty acids, both of which are associated with the physiological changes that occur during transplant rejection. During the procedure, the patient's exhaled breath is collected into a sorbent trap, and a sample of room air is simultaneously obtained for comparison. The analysis of these samples is conducted using gas chromatography/mass spectrometry, a sophisticated technique that allows for the precise measurement of chemical compounds. The results from the breath test are then compared to a recent endomyocardial biopsy result, which must be conducted within the last month. This comparison is crucial as it helps to calculate the probability of transplant rejection, providing valuable information to healthcare providers in managing the patient's post-transplant care.

1. Indications

The breath test for heart transplant rejection is indicated for use in patients who have received an allograft heart transplant within the past year. This test is specifically aimed at detecting grade 3 heart transplant rejection, which is a critical condition that requires timely intervention. The following conditions and symptoms may warrant the use of this test:

Heart Transplantation Patients who have undergone heart transplantation and are at risk for rejection.
Monitoring for Rejection Individuals requiring ongoing assessment for potential grade 3 rejection following transplantation.
Adjunct to Biopsy Patients for whom endomyocardial biopsy results need to be corroborated with non-invasive testing methods.

2. Procedure

The procedure for conducting the breath test for heart transplant rejection involves several key steps that ensure accurate measurement and analysis of the patient's exhaled breath. The following procedural steps are outlined:

Step 1: Sample Collection The patient is instructed to exhale into a sorbent trap, which captures the breath sample. Simultaneously, a sample of room air is collected to serve as a control for comparison. This dual sampling is essential for accurate analysis of the methylated alkanes present in the breath.
Step 2: Sample Analysis The collected breath sample and the room air sample are subjected to gas chromatography/mass spectrometry (GC/MS). This advanced analytical technique separates and identifies the chemical compounds present in the samples, focusing on the methylated alkanes that are indicative of oxidative stress and potential transplant rejection.
Step 3: Data Comparison The results obtained from the breath test are compared to a recent endomyocardial biopsy result, which must have been performed within the last month. This comparison is crucial as it allows healthcare providers to calculate the probability of transplant rejection based on the levels of methylated alkanes detected in the patient's breath.

3. Post-Procedure

After the breath test is completed, the patient may resume normal activities as there are no invasive procedures involved. The results of the breath test will be analyzed and interpreted in conjunction with the recent endomyocardial biopsy findings. Healthcare providers will discuss the results with the patient, including any necessary follow-up actions or additional monitoring that may be required based on the probability of transplant rejection indicated by the test. Continuous monitoring and assessment are essential for managing the patient's health post-transplant, ensuring timely intervention if rejection is suspected.

Short Descr	BREATH TEST HEART REJECT
Medium Descr	BREATH TEST HEART TRANSPLANT REJECTION
Long Descr	Breath test for heart transplant rejection
Status Code	Non-Covered Service
Global Days	XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC)	9 - Not Applicable
Multiple Procedures (51)	9 - Concept does not apply.
Bilateral Surgery (50)	9 - Concept does not apply.
Physician Supervisions	09 - Concept does not apply.
Assistant Surgeon (80, 82)	9 - Concept does not apply.
Co-Surgeons (62)	9 - Concept does not apply.
Team Surgery (66)	9 - Concept does not apply.
Diagnostic Imaging Family	99 - Concept Does Not Apply
APC Status Indicator	Non-Covered Service, not paid under OPPS
Type of Service (TOS)	5 - Diagnostic Laboratory
Berenson-Eggers TOS (BETOS)	T2D - Other tests - other
MUE	Not applicable/unspecified.
CCS Clinical Classification	62 - Other diagnostic cardiovascular procedures