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The CPT® Code 80202 refers to the laboratory test for measuring vancomycin levels in the blood. Vancomycin, also known by its brand name Vancocin, is a glycopeptide antibiotic that is primarily used to treat severe or serious bacterial infections. This medication is particularly important in the management of systemic infections, where it is typically administered via intravenous infusion. In cases of intestinal infections, such as colitis or those caused by Clostridium difficile, vancomycin can be taken orally. Monitoring the blood levels of vancomycin is crucial due to the drug's potential to cause auditory toxicity, which can lead to hearing loss if levels are not properly managed. The testing involves obtaining blood samples at various times: random samples can be drawn at any time, while peak and trough levels are specifically time-dependent. A trough level is collected 10 minutes before the intravenous infusion begins, and a peak level is drawn 1 to 2 hours after the infusion has been completed. The blood samples are obtained through a venipuncture, which is a separate reportable procedure. The serum from the blood is then analyzed using a fluorescence polarization immunoassay, a method that allows for accurate measurement of the drug levels in the bloodstream.
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The vancomycin blood test (CPT® Code 80202) is indicated for the following conditions:
The procedure for measuring vancomycin levels involves several key steps:
After the blood samples have been collected and sent for analysis, there are no specific post-procedure care requirements for the patient. However, it is essential to monitor the patient for any signs of adverse reactions to vancomycin, particularly auditory toxicity. The results of the vancomycin level tests will guide further treatment decisions, including dosage adjustments if necessary. Regular monitoring is typically recommended every 2-3 days following the initiation of therapy to ensure therapeutic levels are maintained and to minimize the risk of toxicity.
| Short Descr | ASSAY OF VANCOMYCIN | Medium Descr | DRUG SCREEN QUANTITATIVE VANCOMYCIN | Long Descr | Vancomycin | 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. | 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. | 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. | GW | Service not related to the hospice patient's terminal condition | 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. | Q4 | Service for ordering/referring physician qualifies as a service exemption | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | CR | Catastrophe/disaster related | GA | Waiver of liability statement issued as required by payer policy, individual case | GC | This service has been performed in part by a resident under the direction of a teaching physician | 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 | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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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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