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The CPT® Code 80180 refers to a laboratory test that measures the levels of mycophenolate, specifically mycophenolic acid, in the blood. Mycophenolate is an immunosuppressant medication commonly used in patients who have undergone organ transplants, including kidney, liver, heart, or lung transplants. The primary purpose of this test is to monitor the concentration of mycophenolate in the bloodstream to ensure that therapeutic levels are maintained, which is crucial for preventing organ rejection. The test is typically performed through pre-dose (trough) blood draws, meaning that the blood sample is collected just before the next dose of medication is administered. This timing is essential for accurately assessing the drug's levels in the body. The blood sample is obtained via venipuncture, a procedure that involves puncturing a vein to collect blood. The analysis of the serum or plasma is conducted using advanced techniques such as high-performance liquid chromatography (HPLC) or quantitative tandem mass spectrometry, which allows for precise measurement of mycophenolic acid and its metabolites. Monitoring these levels helps healthcare providers adjust dosages as necessary to optimize patient outcomes and minimize the risk of side effects associated with improper dosing.
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The mycophenolate level test (CPT® Code 80180) is indicated for the following conditions:
The procedure for obtaining mycophenolate levels involves several key steps:
After the blood sample has been collected, there are generally no specific post-procedure care requirements for the patient. However, patients may be advised to apply pressure to the venipuncture site to minimize bruising and bleeding. The results of the mycophenolate level test will be communicated to the healthcare provider, who will use this information to make any necessary adjustments to the patient's medication regimen to ensure optimal therapeutic levels are maintained.
| Short Descr | DRUG SCRN QUAN MYCOPHENOLATE | Medium Descr | DRUG SCREEN QUANTITATIVE MYCOPHENOLATE | Long Descr | Mycophenolate (mycophenolic acid) | 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. | 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. | 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 |
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| 2014-01-01 | Added | Added |
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