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The CPT® Code 80158 refers to a laboratory test specifically designed to measure the levels of cyclosporine in the blood. Cyclosporine is an immunosuppressant medication that plays a critical role in preventing the body from rejecting transplanted organs, such as the kidney, liver, heart, and lung. It is also utilized in the treatment of various autoimmune conditions, including rheumatoid arthritis, psoriasis, aplastic anemia, and Crohn's disease. The drug is available in multiple forms, including oral capsules, injectable solutions, and an ophthalmic solution known as RESTASIS, which is used to enhance tear production in patients suffering from keratoconjunctivitis sicca, commonly referred to as severe dry eyes. Monitoring cyclosporine levels is essential for transplant patients, particularly during the initial stages of therapy, where levels may need to be assessed daily. As treatment progresses, the frequency of testing typically tapers to once or twice a week, and eventually to once every one to two months for routine monitoring. For optimal accuracy, blood specimens for cyclosporine testing are ideally collected 12 hours after the last dose. In the case of new transplant patients, peak levels are often drawn two hours post-dose, while trough levels are collected immediately before the next dose. The blood sample is obtained through a separately reportable venipuncture, and the analysis is conducted using liquid chromatography-tandem mass spectrometry. It is important to note that Sandimmune, a specific formulation of cyclosporine, may be tested using either chromatographic or immunoassay techniques, which can yield different results. Therefore, it is crucial to document the testing technique used for accurate comparison with previous levels.
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The cyclosporine blood test (CPT® Code 80158) is indicated for several specific conditions and monitoring requirements, particularly in the context of organ transplantation and autoimmune diseases. The following are the primary indications for performing this test:
The procedure for testing cyclosporine levels involves several critical steps to ensure accurate results. The following outlines the procedural steps involved in obtaining and analyzing the blood sample:
After the blood sample has been collected and sent for analysis, there are no specific post-procedure care instructions for the patient. However, it is important for healthcare providers to communicate the expected timeline for receiving results and any follow-up actions that may be necessary based on the test outcomes. Patients should be advised to continue their prescribed cyclosporine regimen and to report any adverse effects or concerns to their healthcare provider. Regular monitoring of cyclosporine levels is essential to ensure therapeutic effectiveness and to minimize the risk of toxicity or organ rejection.
| Short Descr | DRUG ASSAY CYCLOSPORINE | Medium Descr | DRUG ASSAY CYCLOSPORINE | Long Descr | Cyclosporine | 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) | T1H - Lab tests - other (non-Medicare fee schedule) | MUE | 1 | CCS Clinical Classification | 235 - Other Laboratory |
| 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. | 26 | Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number. | 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 | 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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| 2013-01-01 | Changed | Medium description changed per AMA 2013 corrections document dated January 25, 2013. |
| 1993-01-01 | Added | First appearance in code book in 1993. |
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