CPT® Code 82131

Official Description

Amino acids; single, quantitative, each specimen

Common Language Description

The CPT® Code 82131 refers to a laboratory test that quantitatively measures the presence of a single amino acid in a specimen, which can be either blood or urine. Amino acids are essential organic compounds that serve as the building blocks of proteins and play a critical role in various metabolic processes within the body. This test is particularly relevant for individuals suspected of having an inborn error of metabolism, a group of genetic disorders that disrupt normal metabolic pathways. The clinical manifestations of these disorders often present in infancy or early childhood and can vary significantly based on the specific amino acid involved. Symptoms may include feeding difficulties, poor growth or failure to thrive, seizures, muscle weakness, renal or liver dysfunction, developmental delays, and cognitive impairments. To perform this test, a blood sample is typically collected through venipuncture, which is a procedure that involves puncturing a vein to obtain blood. Alternatively, a urine sample can be collected either through a voided specimen or catheterization. The analysis of the serum, plasma, or urine is conducted using advanced techniques such as liquid chromatography-tandem mass spectrometry, which allows for precise measurement of amino acid concentrations. The quantitative assessment of amino acids is crucial for monitoring treatment and dietary adherence in patients with specific metabolic disorders, including phenylketonuria (PKU), cystinuria, and Hartnup disease. In these cases, the test results can guide clinical decisions and help manage the patient's condition effectively.

1. Indications

The CPT® Code 82131 is indicated for use in the following scenarios:

Inborn Errors of Metabolism This test is performed for individuals suspected of having metabolic disorders that affect amino acid metabolism.
Monitoring Treatment It is utilized to monitor treatment and dietary compliance in patients diagnosed with phenylketonuria (PKU), cystinuria, and Hartnup disease.
Clinical Symptoms The test is indicated when patients present with symptoms such as feeding problems, poor growth or failure to thrive, seizures, muscle weakness, renal or liver failure, developmental delays, and cognitive deficits.

2. Procedure

The procedure for conducting the test associated with CPT® Code 82131 involves several key steps:

Step 1: Sample Collection A blood sample is obtained through venipuncture, which involves inserting a needle into a vein to draw blood. Alternatively, a urine sample can be collected either by having the patient void into a container or through catheterization, depending on the clinical situation and the need for a more controlled sample.
Step 2: Sample Preparation Once the samples are collected, they are prepared for analysis. This may involve processing the blood to separate serum or plasma, as well as preparing the urine sample for testing.
Step 3: Analytical Testing The prepared samples are then analyzed using liquid chromatography-tandem mass spectrometry (LC-MS/MS). This sophisticated technique allows for the precise quantification of amino acids present in the specimens.
Step 4: Result Interpretation After the analysis is complete, the results are interpreted by qualified laboratory personnel. The quantitative amount of the specific amino acid is reported, which can then be used to inform clinical decisions regarding the patient's treatment and dietary management.

3. Post-Procedure

Post-procedure care for patients undergoing testing with CPT® Code 82131 typically involves monitoring for any immediate complications related to blood draw, such as bruising or discomfort at the venipuncture site. Patients may be advised to resume normal activities unless otherwise directed by their healthcare provider. The results of the amino acid testing will be reviewed in the context of the patient's clinical presentation and history, and follow-up appointments may be scheduled to discuss the findings and any necessary adjustments to treatment or dietary plans based on the results.

Short Descr	AMINO ACIDS SINGLE QUANT
Medium Descr	AMINO ACIDS 1 QUANTITATIVE EACH SPECIMEN
Long Descr	Amino acids; single, quantitative, each specimen
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	2
CCS Clinical Classification	200 - Nonoperative urinary system measurements

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.
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
GW	Service not related to the hospice patient's terminal condition