Need help choosing the right code?
Ask CasePilot about procedures, modifiers, bundling, and coding guidance.
Try CasePilot© Copyright 2026 American Medical Association. All rights reserved.
The CPT® Code 80175 refers to a laboratory test specifically designed to measure the levels of lamotrigine in the blood. Lamotrigine, marketed under the brand name Lamictal, is classified as an anticonvulsant medication belonging to the phenyltriazine class. It is primarily utilized in the management of seizure disorders, including epilepsy, and is also indicated for the treatment of bipolar disorder. In addition to its approved uses, lamotrigine may be prescribed off-label for various conditions such as peripheral neuropathy, migraine headaches, and depression that does not involve manic episodes. The testing process involves obtaining a blood sample through a procedure known as venipuncture, which is separately reportable. The analysis of the blood sample is conducted using a quantitative enzyme immunoassay, which allows for precise measurement of the drug's concentration in serum and/or plasma, thereby aiding healthcare providers in monitoring therapeutic levels and adjusting dosages as necessary.
© Copyright 2026 Coding Ahead. All rights reserved.
The lamotrigine level test (CPT® Code 80175) is indicated for several specific clinical scenarios, primarily related to the management of conditions treated with lamotrigine. The following are the explicit indications for performing this test:
The procedure for measuring lamotrigine levels involves several key steps that ensure accurate and reliable results. The following outlines the procedural steps involved:
After the lamotrigine level test is completed, the healthcare provider will review the results to determine if the lamotrigine levels are within the therapeutic range. If the levels are too low, the provider may consider increasing the dosage, while excessively high levels may necessitate a reduction in dosage or a reevaluation of the treatment plan. Patients may be advised to continue monitoring their symptoms and report any side effects or concerns to their healthcare provider. Additionally, follow-up testing may be scheduled to ensure ongoing efficacy and safety of the lamotrigine therapy.
| Short Descr | DRUG SCREEN QUAN LAMOTRIGINE | Medium Descr | DRUG SCREEN QUANTITATIVE LAMOTRIGINE | Long Descr | Lamotrigine | 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 |
| 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. | GW | Service not related to the hospice patient's terminal condition | 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. | 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. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | GA | Waiver of liability statement issued as required by payer policy, individual case | GR | This service was performed in whole or in part by a resident in a department of veterans affairs medical center or clinic, supervised in accordance with va policy | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit | GZ | Item or service expected to be denied as not reasonable and necessary | X5 | Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician |
|
Date
|
Action
|
Notes
|
|---|---|---|
| 2014-01-01 | Added | Added |
Get instant expert-level medical coding assistance.