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The CPT® Code 80151 refers to a laboratory test specifically designed to monitor therapeutic levels of amiodarone, a critical medication utilized in the management of life-threatening arrhythmias. Amiodarone is particularly effective for conditions such as ventricular fibrillation, unstable ventricular tachycardia, and atrial fibrillation, especially in patients who have shown minimal or no response to other antiarrhythmic agents. One of the notable characteristics of amiodarone is its long half-life, which results in a prolonged elimination period from the body, averaging around 53 days. This extended duration necessitates careful monitoring to ensure that therapeutic levels are maintained and to avoid potential toxicity. The metabolism of amiodarone occurs primarily in the liver and intestines, where it is converted into its active metabolite, N-desethylamiodarone (DEA). This metabolite retains similar activity and serum concentrations as the parent drug, complicating the monitoring process. Clinicians must be aware of the adverse effects associated with amiodarone, which can include thyroid dysfunction, as well as neurological, hepatic, and gastrointestinal toxicity. For effective monitoring, the therapeutic concentration trough level of amiodarone is established between 0.5 to 2.0 mcg/mL, with levels exceeding 2.5 mcg/mL considered toxic. To obtain accurate measurements, a blood specimen is collected prior to dosing to ensure a trough draw at steady state concentration. Following collection, plasma or serum must be separated from cellular components within two hours and placed in an appropriate tube for analysis. The quantitative assessment of amiodarone levels is performed using liquid chromatography-tandem mass spectrometry, which provides precise values for the concentration of the drug. While the assay also reports the concentration of its active metabolite, it is important to note that no established therapeutic range exists for DEA, although its levels are generally comparable to those of the parent drug.
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The laboratory test associated with CPT® Code 80151 is indicated for the monitoring of therapeutic levels of amiodarone in patients undergoing treatment for specific life-threatening arrhythmias. The following conditions are explicitly recognized as indications for this procedure:
The procedure for monitoring amiodarone levels involves several critical steps to ensure accurate assessment of the drug's concentration in the patient's system. The following procedural steps are outlined:
Post-procedure care involves monitoring the patient for any adverse effects related to amiodarone therapy, particularly if toxic levels are detected. Clinicians should review the test results promptly to make necessary adjustments to the patient's medication regimen. Continuous assessment of thyroid function and other potential side effects is also recommended, given the known risks associated with amiodarone use. Regular follow-up testing may be required to ensure that the drug levels remain within the therapeutic range and to prevent complications arising from prolonged exposure to the medication.
| Short Descr | DRUG ASSAY AMIODARONE | Medium Descr | DRUG ASSAY AMIODARONE | Long Descr | Amiodarone | Status Code | Statutory Exclusion (from MPFS, may be paid under other methodologies) | 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 | CLIA Waived (QW) | No | APC Status Indicator | Conditionally packaged laboratory tests | Type of Service (TOS) | 5 - Diagnostic Laboratory | Berenson-Eggers TOS (BETOS) | none | MUE | 1 |
| 90 | Reference (outside) laboratory: when laboratory procedures are performed by a party other than the treating or reporting physician or other qualified health care professional, the procedure may be identified by adding modifier 90 to the usual procedure number. | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 91 | Repeat clinical diagnostic laboratory test: in the course of treatment of the patient, it may be necessary to repeat the same laboratory test on the same day to obtain subsequent (multiple) test results. under these circumstances, the laboratory test performed can be identified by its usual procedure number and the addition of modifier 91. note: this modifier may not be used when tests are rerun to confirm initial results; due to testing problems with specimens or equipment; or for any other reason when a normal, one-time, reportable result is all that is required. this modifier may not be used when other code(s) describe a series of test results (eg, glucose tolerance tests, evocative/suppression testing). this modifier may only be used for laboratory test(s) performed more than once on the same day on the same patient. | GA | Waiver of liability statement issued as required by payer policy, individual case | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GW | Service not related to the hospice patient's terminal condition | Q4 | Service for ordering/referring physician qualifies as a service exemption |
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| 2021-01-01 | Added | Code added. |
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