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The CPT® Code 82523 refers to the measurement of collagen cross links using any method, specifically focusing on the peptide fragments known as N-Telopeptide and C-Telopeptide. These fragments are derived from the protein matrix of bone and serve as important biomarkers in assessing bone metabolism. The N-Telopeptide can be detected in both serum and urine, making it a versatile marker for evaluating bone resorption. In clinical practice, a baseline measurement of N-Telopeptide is typically obtained before initiating treatment with bisphosphonates or hormone replacement therapy, particularly in postmenopausal women or individuals diagnosed with osteopenia. This initial assessment is crucial for establishing a reference point for future evaluations. Following the initiation of therapy, the N-Telopeptide levels are monitored at intervals of three months and six months to determine the effectiveness of the treatment. Similarly, C-Telopeptide, which is exclusively measured in serum, is utilized to monitor the therapeutic response to bisphosphonates or hormone replacement therapy in the same patient populations. The collection of samples for these tests involves venipuncture for blood samples, which must be reported separately, while urine samples can be collected randomly or over a 24-hour period. The testing methodologies employed include quantitative chemiluminescent immunoassay for urine N-Telopeptide, quantitative enzyme-linked immunosorbent assay for serum N-Telopeptide, and quantitative electrochemiluminescent immunoassay for serum C-Telopeptide. These tests provide valuable insights into bone health and the effectiveness of ongoing treatment regimens.
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The procedure associated with CPT® Code 82523 is indicated for the following conditions and circumstances:
The procedure for obtaining the necessary samples for the collagen cross links test involves several key steps:
After the procedure, the collected samples are sent to a laboratory for analysis. The results of the tests will be used to monitor the patient's response to treatment with bisphosphonates or hormone replacement therapy. It is important for healthcare providers to review the results at the specified intervals of three months and six months to determine the effectiveness of the ongoing therapy. Patients may not require any specific post-procedure care, but they should be informed about the importance of follow-up appointments to discuss their results and any necessary adjustments to their treatment plan.
| Short Descr | COLLAGEN CROSSLINKS | Medium Descr | COLLAGEN CROSS LINKS ANY METHOD | Long Descr | Collagen cross links, any method | 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) | Yes | 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. | 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. | GA | Waiver of liability statement issued as required by payer policy, individual case | Q4 | Service for ordering/referring physician qualifies as a service exemption | GZ | Item or service expected to be denied as not reasonable and necessary | QW | Clia waived test | 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 | 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. | 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. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 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. | GW | Service not related to the hospice patient's terminal condition | GX | Notice of liability issued, voluntary under payer policy | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 1997-01-01 | Added | First appearance in code book in 1997. |
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