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The CPT® Code 80414 refers to a specific laboratory test known as the chorionic gonadotropin stimulation panel, which is designed to assess the testosterone response in patients. This panel is particularly relevant for evaluating infants who present with ambiguous genitalia and palpable gonads, as well as males experiencing delayed puberty or undescended testes. Additionally, it serves to confirm the presence of active testicular tissue. The test involves measuring the baseline level of testosterone prior to any stimulation and then assessing the testosterone levels following the administration of an evocative agent, specifically human chorionic gonadotropin (hCG). The procedure begins with the collection of three blood samples, which are drawn 15-20 minutes apart and pooled together to establish a baseline testosterone level. After the baseline measurement, an intramuscular or subcutaneous injection of 5,000 units of hCG is administered. Following this injection, a post-response sample is collected three days later, again involving three blood samples drawn 15-20 minutes apart and pooled for analysis. The serum or plasma obtained from these samples is then tested using a quantitative electrochemiluminescent immunoassay, providing a detailed evaluation of the testosterone response to the stimulation.
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The chorionic gonadotropin stimulation panel is indicated for specific clinical scenarios, particularly in the evaluation of male patients with certain conditions. The following indications are explicitly provided for this procedure:
The procedure for the chorionic gonadotropin stimulation panel involves several critical steps to ensure accurate measurement of testosterone levels. The first step is the collection of a baseline testosterone sample. This is achieved through a separately reportable venipuncture, where three blood samples are drawn from the patient at intervals of 15-20 minutes apart. These samples are then pooled together to measure the initial testosterone level, providing a baseline for comparison.
Following the baseline measurement, the next step involves the administration of the evocative agent, human chorionic gonadotropin (hCG). A dose of 5,000 units of hCG is administered either intramuscularly or subcutaneously. This injection stimulates the testes to produce testosterone, which is crucial for the subsequent evaluation of the testosterone response.
Three days after the hCG injection, a post-response sample is collected to assess the testosterone levels following stimulation. Similar to the baseline collection, this involves a separately reportable venipuncture where three blood samples are drawn at 15-20 minute intervals and pooled together for analysis.
The serum or plasma obtained from both the baseline and post-response samples is then subjected to testing using a quantitative electrochemiluminescent immunoassay, which provides precise measurements of testosterone levels before and after stimulation.
After the completion of the chorionic gonadotropin stimulation panel, there are no specific post-procedure care instructions mentioned. However, it is essential for healthcare providers to monitor the patient for any potential side effects from the hCG injection, although such effects are typically minimal. The results from the testosterone measurements will be analyzed and interpreted in the context of the patient's clinical presentation, aiding in the diagnosis and management of the underlying conditions. Follow-up consultations may be necessary to discuss the results and any further steps required based on the findings of the test.
| Short Descr | TESTOSTERONE RESPONSE PANEL | Medium Descr | CHORNC GONAD STIMJ PANEL TESTOSTERONE RESPONSE | Long Descr | Chorionic gonadotropin stimulation panel; testosterone response This panel must include the following: Testosterone (84403 x 2 on 3 pooled blood samples) | 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 | 1 | CCS Clinical Classification | 235 - Other Laboratory |
| 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. | 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. |
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| 2021-01-01 | Changed | Short and medium descriptions changed. |
| 2009-01-01 | Changed | Code description changed. |
| 1994-01-01 | Added | First appearance in code book in 1994. |
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