CPT® Code 82205

Code deleted, see 80345

Official Description

Barbiturates, not elsewhere specified

Common Language Description

The CPT® Code 82205 refers to a laboratory test specifically designed for the identification of barbiturates in biological specimens such as blood, urine, or meconium stool. Barbiturates are a class of drugs that act as central nervous system depressants, which means they can slow down brain activity and are often used in clinical settings for purposes such as pain management and seizure control. However, due to their addictive nature, barbiturates also pose a risk for abuse and dependency. Common barbiturate compounds include Butalbital, Phenobarbital, Pentobarbital, Mephobarbital, Amobarbital, and Secobarbital. Testing for barbiturates is particularly important in situations where there is a suspicion of overdose or potential poisoning, as well as in cases where an individual exhibits symptoms of toxicity while undergoing therapeutic treatment with these drugs. The results of such tests can provide critical information; for instance, the absence of a barbiturate that is expected to be present may indicate issues such as noncompliance with prescribed medication, poor absorption of the drug, inappropriate timing of specimen collection, or the possibility that the specimen has been diluted or adulterated. Additionally, barbiturate testing can be utilized to assess maternal drug use during pregnancy by analyzing the meconium stool of a newborn, which can reflect the mother's barbiturate consumption in the last four to five months of gestation. The collection of samples for this test involves obtaining a blood sample through a separately reportable venipuncture, a urine sample via voided specimen or catheterization, and meconium stool collected from the infant's diaper. The analytical methods employed for testing serum/plasma and urine include quantitative gas chromatography-mass spectrometry, while meconium is analyzed using either quantitative gas or liquid chromatography-mass spectrometry.

1. Indications

The CPT® Code 82205 is indicated for use in various clinical scenarios where barbiturate presence needs to be assessed. The following conditions may warrant this laboratory test:

Suspected Overdose Testing may be performed when there is a clinical suspicion of barbiturate overdose, which can lead to severe central nervous system depression and potentially life-threatening situations.
Possible Poisoning The test is indicated in cases where poisoning by barbiturates is suspected, allowing for timely diagnosis and intervention.
Symptoms of Toxicity When an individual exhibits symptoms consistent with barbiturate toxicity while being treated therapeutically, testing can help confirm the presence of the drug.
Maternal Drug Use Assessment Testing of meconium stool can be utilized to determine maternal barbiturate use during the last four to five months of pregnancy, providing insights into potential neonatal exposure.

2. Procedure

The procedure for conducting the barbiturate test under CPT® Code 82205 involves several key steps, each critical for accurate results:

Sample Collection Blood samples are obtained through a separately reportable venipuncture, ensuring that the specimen is collected in a manner that minimizes contamination and preserves the integrity of the sample. Urine samples can be collected either as a voided specimen or through catheterization, depending on the clinical situation and patient condition. Additionally, meconium stool is collected from the infant's diaper, which is essential for assessing maternal drug use during pregnancy.
Sample Preparation Once collected, the samples must be properly prepared for analysis. This involves labeling and storing the specimens under appropriate conditions to prevent degradation or contamination before testing.
Analytical Testing The testing of serum/plasma and urine samples is performed using quantitative gas chromatography-mass spectrometry (GC-MS), a highly sensitive and specific method that allows for the accurate identification and quantification of barbiturates. For meconium samples, either quantitative gas chromatography or liquid chromatography-mass spectrometry is employed, providing reliable results regarding the presence of barbiturate compounds.

3. Post-Procedure

After the completion of the barbiturate testing procedure, the following post-procedure considerations are important:

Results from the barbiturate test will be analyzed and reported, providing critical information regarding the presence or absence of barbiturates in the tested specimens. Clinicians should interpret these results in the context of the patient's clinical presentation and history. If barbiturates are detected, appropriate clinical management should be initiated based on the severity of the situation, particularly in cases of overdose or toxicity. Additionally, if meconium testing indicates maternal use of barbiturates, further evaluation and counseling may be necessary to address potential implications for the newborn. It is also essential to ensure that all specimens are disposed of according to laboratory safety protocols to maintain compliance with health regulations.

Short Descr	ASSAY OF BARBITURATES
Medium Descr	BARBITURATES NOT ELSEWHERE SPECIFIED
Long Descr	Barbiturates, not elsewhere specified
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	9 - 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
APC Status Indicator	Items and Services Packaged into APC Rates
Type of Service (TOS)	5 - Diagnostic Laboratory
Berenson-Eggers TOS (BETOS)	T1H - Lab tests - other (non-Medicare fee schedule)
MUE	Not applicable/unspecified.
CCS Clinical Classification	235 - Other Laboratory