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Official Description

Tacrolimus

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 80197 refers to a laboratory test specifically designed to measure the levels of tacrolimus in the blood. Tacrolimus, commonly known by its brand name Prograf, is an immunosuppressant medication that plays a critical role in preventing organ rejection in transplant patients. It works by inhibiting the activity of certain white blood cells, which are essential for the immune response against transplanted organs such as the kidney, liver, heart, and lung. The administration of tacrolimus is typically done intravenously, either as a standalone treatment or in conjunction with other immunosuppressive agents to enhance its effectiveness. Due to its narrow therapeutic range, careful monitoring of tacrolimus levels is essential to ensure that patients receive the appropriate dosage. Initially, blood levels may be assessed daily when starting therapy, then tapering to 1-2 times per week, and eventually to once every 1-2 months for routine monitoring. The blood specimen for this test is collected as a trough level, which means it is taken just before the next scheduled dose and at least 12 hours after the last dose. The testing process involves obtaining a blood sample through a separately reportable venipuncture, followed by analysis using liquid chromatography-tandem mass spectrometry. It is important to note that tacrolimus can also be tested using chromatographic or immunoassay techniques, which may yield slightly different results; therefore, the specific technique used should be documented when comparing current results with previous levels.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The tacrolimus blood test (CPT® Code 80197) is indicated for the following conditions:

  • Organ Transplantation This test is primarily performed for patients who have undergone organ transplantation, as it helps monitor the levels of tacrolimus to prevent organ rejection.
  • Immunosuppressive Therapy It is also indicated for patients receiving tacrolimus as part of their immunosuppressive therapy regimen, ensuring that the drug levels remain within the therapeutic range.
  • Adjustment of Dosage The test is necessary for adjusting the dosage of tacrolimus based on the measured blood levels, particularly during the initial phase of treatment or when there are changes in the patient's condition.

2. Procedure

The procedure for measuring tacrolimus levels involves several key steps:

  • Step 1: Patient Preparation Prior to the blood draw, the patient should be informed about the test and its purpose. It is essential to ensure that the blood sample is collected as a trough level, meaning it should be taken just before the next scheduled dose of tacrolimus and at least 12 hours after the last dose.
  • Step 2: Venipuncture A qualified healthcare professional will perform a venipuncture to obtain a blood sample. This procedure involves inserting a needle into a vein, typically in the arm, to draw the necessary volume of blood for testing. The venipuncture is a separately reportable procedure and must be documented accordingly.
  • Step 3: Sample Handling Once the blood sample is collected, it should be properly labeled and handled to prevent contamination. The sample is then sent to the laboratory for analysis.
  • Step 4: Laboratory Analysis In the laboratory, the whole blood sample is analyzed using liquid chromatography-tandem mass spectrometry, which is the preferred method for accurate measurement of tacrolimus levels. It is important to note that tacrolimus can also be tested using chromatographic or immunoassay techniques, and the specific method used should be recorded for comparison with previous results.

3. Post-Procedure

After the blood sample has been collected and sent for analysis, there are no specific post-procedure care requirements for the patient. However, it is important for healthcare providers to monitor the patient’s response to tacrolimus therapy and adjust dosages as necessary based on the test results. Patients should be informed about the importance of regular monitoring and adherence to their medication schedule to maintain therapeutic levels and prevent organ rejection.

Short Descr ASSAY OF TACROLIMUS
Medium Descr DRUG SCREEN QUANTITATIVE TACROLIMUS
Long Descr Tacrolimus
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 2
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.
Q4 Service for ordering/referring physician qualifies as a service exemption
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
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.
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.
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.
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.
AY Item or service furnished to an esrd patient that is not for the treatment of esrd
CR Catastrophe/disaster related
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
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
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
Date
Action
Notes
2013-01-01 Changed Medium description changed per AMA 2013 corrections document dated January 25, 2013.
1997-01-01 Added First appearance in code book in 1997.
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