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The CPT® Code 80321 refers to a laboratory test specifically designed to measure alcohol biomarkers in various biological samples, including serum, plasma, urine, saliva, or hair. This test is crucial for detecting the presence of alcohol exposure or ingestion, which can indicate current drinking habits or recent episodes of relapse or binge drinking. The biomarkers assessed in this test include carbohydrate-deficient transferrin (CDT), fatty acid ethyl esters (FAEE), ethyl sulfate (EtS), ethyl glucuronide (EtG), and phosphatidylethanol (PEth). Each of these biomarkers serves a unique purpose in evaluating alcohol consumption patterns. For instance, CDT is particularly useful as a marker for chronic alcoholism, as it reflects changes in the glycosylation pattern of transferrin that occur with prolonged alcohol use. Notably, the levels of CDT can return to normal within a few weeks following alcohol abstinence. FAEE levels can help distinguish between chronic alcohol abuse and binge drinking, while EtS and EtG are often tested together to enhance the sensitivity of detecting recent alcohol consumption. PEth, on the other hand, is indicative of binge or prolonged drinking and is less sensitive to incidental alcohol exposure. The testing methodologies employed for these biomarkers include advanced techniques such as gas chromatography/mass spectrometry and high-performance liquid chromatography-tandem mass spectrometry, ensuring accurate and reliable results.
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The laboratory test for alcohol biomarkers (CPT® Code 80321) is indicated for the following conditions:
The procedure for testing alcohol biomarkers involves several key steps, each critical for ensuring accurate results:
After the alcohol biomarker testing is completed, the results are typically reviewed by healthcare professionals to interpret the findings in the context of the patient's clinical history and current condition. Depending on the results, further evaluation or intervention may be warranted. It is important to note that the presence of certain biomarkers may indicate not only alcohol consumption but also incidental exposure to alcohol-containing products, which should be considered during the assessment. Follow-up care may include counseling or treatment options for individuals identified as having problematic drinking behaviors.
| Short Descr | ALCOHOLS BIOMARKERS 1OR 2 | Medium Descr | DRUG SCREEN QUANT ALCOHOLS BIOMARKERS 1 OR 2 | Long Descr | Alcohol biomarkers; 1 or 2 | Status Code | Not Valid for Medicare Purposes | 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 | APC Status Indicator | Code Not Recognized by OPPS when submitted on Outpatient Hospital Part B Bill Type (12x/13x) | Type of Service (TOS) | 5 - Diagnostic Laboratory | Berenson-Eggers TOS (BETOS) | T2D - Other tests - other | 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. | 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. | 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. | GA | Waiver of liability statement issued as required by payer policy, individual case | 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 |
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| 2015-01-01 | Added | Added |
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