CPT® Code 80322

1. Indications

The CPT® Code 80322 is indicated for use in various clinical scenarios where monitoring alcohol consumption is necessary. The following conditions may warrant the performance of this test:

• Chronic Alcoholism - The test can help identify individuals with a history of chronic alcohol use, particularly through the measurement of carbohydrate-deficient transferrin (CDT).
• Binge Drinking - The presence of fatty acid ethyl esters (FAEE) and phosphatidylethanol (PEth) can indicate episodes of binge drinking, providing insight into recent alcohol consumption patterns.
• Relapse Monitoring - The test is useful for detecting recent relapse in individuals recovering from alcohol use disorder, as biomarkers like ethyl sulfate (EtS) and ethyl glucuronide (EtG) can indicate recent alcohol intake.
• Incidental Alcohol Exposure - Phosphatidylethanol (PEth) testing can help differentiate between incidental exposure to alcohol (e.g., from mouthwash or hand sanitizers) and significant alcohol consumption.

2. Procedure

The procedure for conducting the alcohol biomarker test coded as 80322 involves several key steps, each critical for ensuring accurate results. The following outlines the procedural steps:

• Sample Collection - Biological samples such as serum, plasma, urine, saliva, or hair are collected from the patient. The choice of sample type may depend on the specific biomarkers being tested and the clinical context.
• Biomarker Testing - Each biomarker is tested using specific methodologies. For instance, carbohydrate-deficient transferrin (CDT) is analyzed using standardized affinity chromatography or rapid testing methods like immunoaffinity liquid chromatography coupled with electrospray mass spectrometry. Fatty acid ethyl esters (FAEE) are measured through gas chromatography/mass spectrometry.
• Ethyl Sulfate and Ethyl Glucuronide Testing - These biomarkers are typically tested together to enhance sensitivity. Liquid chromatography-tandem mass spectrometry is employed for analyzing urine and hair samples for ethyl sulfate (EtS) and ethyl glucuronide (EtG).
• Phosphatidylethanol Testing - The abnormal phospholipid, PEth, is measured in serum samples using high-performance liquid chromatography-tandem mass spectrometry. This step is crucial for identifying patterns of binge or prolonged drinking.
• Result Interpretation - After testing, the results are compiled and interpreted by qualified laboratory personnel, who will assess the presence and levels of the biomarkers to provide insights into the patient's alcohol consumption history.

3. Post-Procedure

Post-procedure care for patients undergoing the alcohol biomarker test coded as 80322 typically involves providing the patient with information regarding the testing process and what to expect regarding results. There are no specific recovery requirements associated with the sample collection, as it is a non-invasive procedure for urine, saliva, and hair samples, while serum and plasma collection may involve standard venipuncture. Patients may be advised to follow up with their healthcare provider to discuss the results and any necessary next steps based on the findings. Additionally, it is important to ensure that patients understand the implications of the test results, particularly in the context of treatment for alcohol use disorders or monitoring for relapse.