CPT® Code 82355

Official Description

Calculus; qualitative analysis

Common Language Description

The CPT® Code 82355 refers to the qualitative analysis of renal calculi, commonly known as kidney stones. This laboratory test is essential for understanding the characteristics of these stones, which can form when certain chemicals precipitate and crystallize as the kidneys filter blood and produce urine. The resulting crystals may consist of various minerals, including calcium, magnesium, and cysteine. Kidney stones can lead to significant health issues, such as obstructing urine and blood flow within the kidneys or dislodging and traveling down the ureters. This movement can cause stretching, irritation, and potential damage to the ureteral walls. To conduct the qualitative analysis, urine is collected in a clean container and strained through a fine mesh to capture the calculi. Once collected, the stones are brought to the laboratory, where they undergo a series of steps including washing, drying, weighing, and measuring. The qualitative characteristics of the stones are observed, noting their texture—whether they are rough, smooth, horned, or waxy. Additionally, the stones are cut in half to check for the presence of a nucleus. If a nucleus is identified, it is separated from the shell for individual analysis. In cases where no nucleus is found, the entire stone may be pulverized for further chemical analysis to determine its composition, which includes measuring levels of calcium, magnesium, inorganic phosphate, and oxalate. This comprehensive analysis aids in calculating the stone's overall composition, providing valuable information for diagnosis and treatment.

1. Indications

The qualitative analysis of renal calculi (CPT® Code 82355) is indicated for patients presenting with symptoms or conditions related to kidney stones. These indications may include:

Kidney Stone Formation Patients who have a history of recurrent kidney stones or are currently experiencing symptoms indicative of stone formation.
Obstructive Uropathy Individuals exhibiting signs of obstruction in the urinary tract due to the presence of calculi.
Renal Colic Patients presenting with severe pain in the flank or lower abdomen, which may suggest the movement of stones within the urinary system.
Urinary Tract Infections Patients with recurrent urinary tract infections that may be associated with the presence of kidney stones.

2. Procedure

The procedure for qualitative analysis of renal calculi involves several detailed steps to ensure accurate results. The process begins with the collection of urine in a clean container, which is then strained through a fine mesh to capture any calculi present. This step is crucial as it prevents larger particles from contaminating the sample. Once the calculi are collected, they are transferred to a laboratory setting where they undergo washing and drying to remove any residual urine or contaminants. After drying, the stones are weighed and measured to provide baseline data for analysis. The qualitative characteristics of the stones are then observed, focusing on their texture and appearance, which may include descriptions such as rough, smooth, horned, or waxy. To further investigate the stones, they are cut in half to check for the presence of a nucleus. If a nucleus is found, it is separated from the shell, and both components are analyzed individually to gain insights into their composition. In cases where no nucleus is detected, the entire stone may be pulverized to facilitate a chemical analysis. This analysis measures various components, including calcium, magnesium, inorganic phosphate, and oxalate, which are essential for determining the overall composition of the calculi.

3. Post-Procedure

After the qualitative analysis of renal calculi has been completed, the laboratory will compile the findings into a report that details the characteristics and composition of the stones. This report is crucial for the treating physician, as it aids in diagnosing the underlying causes of stone formation and developing an appropriate treatment plan. Patients may be advised on dietary modifications or medications based on the composition of their stones to prevent future occurrences. Additionally, follow-up appointments may be scheduled to monitor the patient's condition and assess the effectiveness of any interventions implemented. It is important for patients to stay hydrated and adhere to any prescribed treatment regimens to support kidney health and reduce the risk of further stone formation.

Short Descr	CALCULUS ANALYSIS QUAL
Medium Descr	CALCULUS QUALITATIVE ANALYSIS
Long Descr	Calculus; qualitative analysis
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	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.
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.