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The CPT® Code 80285 refers to a laboratory test specifically designed to monitor therapeutic drug levels of voriconazole, an antifungal medication. Voriconazole is primarily utilized in the treatment of invasive fungal infections, including candidemia and pulmonary aspergillosis, particularly in immunocompromised patients. This group includes individuals suffering from conditions such as liver failure, cancer, or those who have undergone organ transplants. In addition to these primary uses, voriconazole may also be prescribed for other serious fungal or yeast infections affecting various body systems, including the skin, stomach, bladder, and kidneys, especially in cases where patients have not responded to or cannot tolerate alternative treatments. The administration of voriconazole is not without risks; it can lead to several adverse effects, including vision problems, kidney issues, severe skin reactions, pancreatitis, muscle twitching, and bone pain, particularly with prolonged use. One of the critical aspects of managing voriconazole therapy is its significant individual variation in pharmacokinetics. This means that the drug's absorption, distribution, metabolism, and excretion can differ widely among patients, leading to a nonlinear and disproportionate increase in drug exposure with higher dosages. Therefore, therapeutic drug monitoring is essential to ensure that a patient's exposure to voriconazole remains within the therapeutic range, optimizing efficacy while minimizing the risk of toxicity. The testing process involves collecting a serum or plasma sample from the patient, which is then diluted with acetonitrile. Following this, the protein precipitate is removed through centrifugation, and a diluted portion of the resulting supernatant is analyzed using tandem mass spectrometry to obtain quantitative results. This meticulous approach ensures accurate monitoring of voriconazole levels in the patient's system, facilitating appropriate adjustments to dosing as necessary.
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The laboratory test associated with CPT® Code 80285 is indicated for monitoring therapeutic drug levels of voriconazole in patients who are at risk for invasive fungal infections. The specific indications for this test include:
The procedure for testing voriconazole levels involves several critical steps to ensure accurate results. The process begins with the collection of a serum or plasma sample from the patient. This sample is then subjected to a dilution process using acetonitrile, which helps to prepare the sample for analysis. Following dilution, the sample undergoes centrifugation to remove the protein precipitate, which is essential for obtaining a clear supernatant for testing. Once the centrifugation is complete, a dilute portion of the supernatant is carefully extracted for further analysis. The final step involves testing this portion using tandem mass spectrometry, a highly sensitive and specific method that provides quantitative results regarding the voriconazole levels in the patient's system. This detailed procedure is crucial for ensuring that the therapeutic drug monitoring is both accurate and reliable, allowing for appropriate dosing adjustments based on the patient's individual response to the medication.
After the voriconazole level testing is completed, the results are typically reviewed by healthcare professionals to determine if the drug levels are within the therapeutic range. If the levels are found to be too low, an increase in dosage may be recommended to enhance efficacy. Conversely, if the levels are too high, indicating potential toxicity, a reduction in dosage or a reevaluation of the treatment plan may be necessary. Continuous monitoring may be required, especially in patients with significant individual variation in drug metabolism. Additionally, healthcare providers should remain vigilant for any adverse effects associated with voriconazole therapy, as these can impact the patient's overall treatment and recovery process.
| Short Descr | DRUG ASSAY VORICONAZOLE | Medium Descr | DRUG ASSAY VORICONAZOLE | Long Descr | Voriconazole | 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. | 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. | GW | Service not related to the hospice patient's terminal condition | Q4 | Service for ordering/referring physician qualifies as a service exemption |
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| 2020-01-01 | Added | Code added. |
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