CPT® Code 80417

Official Description

Peripheral vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 2)

Common Language Description

The CPT® Code 80417 refers to a specific laboratory test known as the Peripheral vein renin stimulation panel, which is utilized primarily for diagnosing renovascular hypertension. This condition may arise from renal artery stenosis (RAS), characterized by a narrowing of the renal blood vessels, often due to the buildup of atherosclerotic plaque or fibromuscular hyperplasia. In cases where hypertension is attributed to RAS, treatment options may include the use of angiotensin-converting enzyme (ACE) inhibitors, which can help manage blood pressure levels. The peripheral vein renin stimulation test is designed to assess the baseline level of renin in the peripheral blood circulation and to observe any changes that occur after the administration of an ACE inhibitor, specifically captopril. To ensure accurate results, patients are required to discontinue any diuretics and ACE inhibitors at least 14 days prior to the test. Additionally, they must adhere to a normal sodium diet, consuming between 100 to 200 mEq of sodium per day for three days leading up to the test. The procedure involves specific positioning of the patient: if a supine test is indicated, the baseline blood sample must be drawn between 8 and 10 a.m. after the patient has been lying down for a minimum of two hours. Conversely, if the test is to be conducted in an upright position, the blood sample should be collected before noon, with the patient sitting or standing for at least two hours prior to the draw. The initial blood sample is obtained through a separate venipuncture, and after administering an oral dose of captopril (25-50 mg), a second blood sample is collected 30 minutes later. The serum or plasma from these samples is then analyzed using quantitative immunoradiometry to evaluate renin levels, providing critical information for the diagnosis and management of renovascular hypertension.

1. Indications

The Peripheral vein renin stimulation panel (CPT® Code 80417) is indicated for the evaluation of renovascular hypertension, which may be associated with the following conditions:

Renal Artery Stenosis (RAS) - A narrowing of the renal arteries that can lead to hypertension, often due to atherosclerotic plaque formation or fibromuscular hyperplasia.

2. Procedure

The procedure for the Peripheral vein renin stimulation panel involves several critical steps to ensure accurate measurement of renin levels in response to captopril administration:

Step 1: Patient Preparation - Prior to the test, the patient must discontinue any diuretics and ACE inhibitors for at least 14 days. Additionally, the patient should follow a normal sodium diet, consuming 100-200 mEq of sodium per day for three days leading up to the test. This preparation is essential to avoid any interference with the renin levels.
Step 2: Positioning for Baseline Blood Draw - Depending on the physician's instructions, the patient will either lie supine or remain upright during the test. For a supine test, the baseline blood sample should be drawn between 8 and 10 a.m. after the patient has been supine for a minimum of two hours. If the test is to be conducted in an upright position, the baseline blood sample must be collected before noon, with the patient sitting or standing for at least two hours prior to the blood draw.
Step 3: Baseline Blood Sample Collection - The initial blood sample is obtained through a separate venipuncture, which is crucial for establishing the baseline renin level in the peripheral circulation.
Step 4: Administration of Captopril - After the baseline sample is collected, the patient is administered an oral dose of captopril, typically ranging from 25 to 50 mg. This medication acts as an ACE inhibitor, which is necessary for the subsequent assessment of renin activity.
Step 5: Second Blood Sample Collection - A second blood sample is obtained 30 minutes after the administration of captopril. This sample will be analyzed to determine the changes in renin levels following the medication.
Step 6: Laboratory Analysis - The serum or plasma from both blood samples is tested using quantitative immunoradiometry to measure renin levels, providing valuable data for diagnosing renovascular hypertension.

3. Post-Procedure

After the completion of the Peripheral vein renin stimulation panel, patients may resume their normal activities unless otherwise directed by their physician. It is important to monitor for any potential side effects from the captopril administration, although significant adverse reactions are uncommon. The results of the renin level tests will be interpreted by the physician to determine the presence of renovascular hypertension and to guide further management or treatment options as necessary.

Short Descr	RENIN STIMULATION PANEL
Medium Descr	PERIPHERAL VEIN RENIN STIMULATION PANEL
Long Descr	Peripheral vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 2)
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

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.