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Official Description

Hydroxychloroquine

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 80220 refers to a laboratory test specifically designed to monitor therapeutic levels of hydroxychloroquine, which is classified as an aminoquinoline and immunosuppressive medication. Hydroxychloroquine is primarily utilized in the treatment and prevention of malaria, as well as in managing autoimmune conditions such as systemic lupus erythematosus and rheumatoid arthritis. Additionally, it has been employed for various off-label uses, including treatment for Q fever and potential applications in COVID-19 management. It is crucial to adhere to the recommended dosage guidelines, which stipulate that the daily intake should not exceed 5 mg per kilogram of body weight. This therapeutic drug assay is essential for measuring the concentration of hydroxychloroquine in the blood, allowing healthcare providers to determine whether toxicity levels are present and to evaluate the associated risk of retinal damage, a known side effect of the medication. The test requires a separately reportable venous blood sample, and while whole blood is traditionally used for testing due to its precision, serum or plasma may also be utilized. It is important to note that drug concentrations can vary significantly among individuals who are on the same dosage regimen, and these concentrations do not necessarily correlate with clinical effectiveness. Target therapeutic ranges for hydroxychloroquine differ depending on the specific condition being treated, with ocular toxicity being a critical concern at levels ranging from 1,177 to 3,503 ng/mL. Various factors, including renal filtration rates, body mass index, genetic differences, and patient adherence to prescribed regimens, can influence the concentration levels of the drug in the bloodstream. Most laboratories employ advanced testing methods such as liquid chromatography mass spectrometry (LC-MS) or liquid chromatography-high-resolution mass spectrometry (LC-HRMS) to ensure accurate measurement of hydroxychloroquine levels.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The laboratory test associated with CPT® Code 80220 is indicated for the following conditions:

  • Monitoring Therapeutic Levels This test is performed to monitor the therapeutic levels of hydroxychloroquine in patients undergoing treatment for malaria, systemic lupus erythematosus, rheumatoid arthritis, and other off-label uses.
  • Assessment of Toxicity It is utilized to assess the risk of hydroxychloroquine toxicity, particularly concerning potential retinal damage.
  • Evaluation of Drug Concentration Variability The test helps evaluate the variability in drug concentrations among patients on the same dosage regimen, which is crucial for ensuring effective treatment.

2. Procedure

The procedure for conducting the hydroxychloroquine therapeutic drug assay involves several key steps:

  • Step 1: Sample Collection A venous blood sample is drawn from the patient. This sample can be collected using standard venipuncture techniques, ensuring that the blood is obtained in a manner that minimizes contamination and preserves the integrity of the sample.
  • Step 2: Sample Preparation The collected blood sample is processed to separate the whole blood into its components, which may include serum or plasma. While whole blood is traditionally used for testing, the choice of sample type may depend on laboratory protocols and the specific testing method employed.
  • Step 3: Analytical Testing The prepared sample undergoes analysis using advanced techniques such as liquid chromatography mass spectrometry (LC-MS) or liquid chromatography-high-resolution mass spectrometry (LC-HRMS). These methods are employed to accurately measure the concentration of hydroxychloroquine in the sample.
  • Step 4: Interpretation of Results Once the analysis is complete, the results are interpreted in the context of the patient's treatment plan. The concentration levels are compared against established therapeutic ranges to determine if the patient is within the target range or at risk for toxicity.

3. Post-Procedure

After the hydroxychloroquine therapeutic drug assay is completed, the following post-procedure considerations should be noted:

Patients may be advised to continue monitoring their symptoms and report any adverse effects, particularly those related to ocular health, as retinal damage is a significant concern with hydroxychloroquine use. Follow-up appointments may be scheduled to discuss the results of the test and to adjust treatment plans as necessary based on the findings. Additionally, healthcare providers should consider factors such as renal function and patient compliance when interpreting the results, as these can significantly impact drug concentration levels.

Short Descr DRUG ASY HYDROXYCHLOROQUINE
Medium Descr DRUG ASSAY HYDROXYCHLOROQUINE
Long Descr Hydroxychloroquine
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) none
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.
Date
Action
Notes
2022-01-01 Added Code added
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