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The CPT® Code 82164 refers to the measurement of angiotensin I-converting enzyme (ACE) through a blood test. ACE is an important enzyme that is primarily produced by endothelial cells, which line the blood vessels throughout the body, with a significant concentration found in the capillary beds of the lungs. Additionally, ACE can be secreted by granulomas, which are abnormal immune or inflammatory tumor-like masses that can form in various conditions. This test is particularly indicated for diagnosing and monitoring sarcoidosis, a condition characterized by the formation of granulomas in various organs. To perform the test, a blood sample is collected via a procedure known as venipuncture, which is separately reportable. The serum obtained from the blood sample is then analyzed using a quantitative enzymatic methodology to determine the ACE levels. Furthermore, cerebral spinal fluid (CSF) can also be tested for ACE levels, which involves obtaining a sample through a lumbar puncture, commonly referred to as a spinal tap. This CSF sample is subsequently tested using quantitative spectrophotometry to measure the ACE concentration accurately.
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The angiotensin I-converting enzyme (ACE) test, represented by CPT® Code 82164, is indicated for specific clinical scenarios, particularly in the diagnosis and monitoring of the following conditions:
The procedure for measuring angiotensin I-converting enzyme (ACE) levels involves several key steps that ensure accurate results. First, a blood sample is obtained through a process known as venipuncture. This procedure involves inserting a needle into a vein, typically in the arm, to draw blood. It is important to note that this venipuncture is a separately reportable procedure. Once the blood sample is collected, it is processed to separate the serum, which is the liquid portion of the blood that contains the ACE enzyme. The serum is then subjected to quantitative enzymatic methodology, a laboratory technique that allows for the precise measurement of ACE levels in the serum. In addition to blood testing, cerebral spinal fluid (CSF) may also be analyzed for ACE levels. To obtain a CSF sample, a lumbar puncture, or spinal tap, is performed. This procedure involves inserting a needle into the lower back to access the spinal canal and collect the CSF. The collected CSF sample is then tested using quantitative spectrophotometry, a method that measures the concentration of ACE in the fluid, providing valuable information for clinical assessment.
After the ACE test is performed, whether through blood or CSF sampling, there are specific considerations for post-procedure care. For venipuncture, patients may experience minor discomfort or bruising at the site of the needle insertion, which typically resolves on its own. It is advisable for patients to monitor the site for any signs of excessive bleeding or infection. In the case of a lumbar puncture, patients may experience headache, back pain, or discomfort following the procedure. Adequate hydration and rest are recommended to alleviate these symptoms. Additionally, healthcare providers may provide specific instructions regarding activity levels and follow-up appointments to discuss the test results and any further necessary evaluations or treatments.
| Short Descr | ANGIOTENSIN I ENZYME TEST | Medium Descr | ANGIOTENSIN I-CONVERTING ENZYME | Long Descr | Angiotensin I - converting enzyme (ACE) | 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 | 233 - Laboratory - Chemistry and Hematology |
| 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. | 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 | Q4 | Service for ordering/referring physician qualifies as a service exemption | GA | Waiver of liability statement issued as required by payer policy, individual case | 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. | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 91 | Repeat clinical diagnostic laboratory test: in the course of treatment of the patient, it may be necessary to repeat the same laboratory test on the same day to obtain subsequent (multiple) test results. under these circumstances, the laboratory test performed can be identified by its usual procedure number and the addition of modifier 91. note: this modifier may not be used when tests are rerun to confirm initial results; due to testing problems with specimens or equipment; or for any other reason when a normal, one-time, reportable result is all that is required. this modifier may not be used when other code(s) describe a series of test results (eg, glucose tolerance tests, evocative/suppression testing). this modifier may only be used for laboratory test(s) performed more than once on the same day on the same patient. | GW | Service not related to the hospice patient's terminal condition | QW | Clia waived test | X5 | Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician |
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| Pre-1990 | Added | Code added. |
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