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The CPT® Code 82638 refers to the dibucaine number (DN) test, which is a specific blood test designed to measure the activity of the enzyme pseudocholinesterase (PChE) in the presence of the drug dibucaine. The dibucaine number is expressed as a percentage, indicating the extent to which the activity of PChE is inhibited by dibucaine. This test is particularly important for identifying individuals who have a deficiency in pseudocholinesterase, a condition that can lead to an increased risk of prolonged paralysis when succinylcholine, a neuromuscular blocking agent, is administered during surgical procedures or other medical interventions. The test is performed by obtaining a blood sample through a venipuncture, which is a procedure that involves inserting a needle into a vein to collect blood. The serum or plasma obtained from the blood sample is then analyzed using a quantitative enzymatic methodology to determine the dibucaine number accurately. This information is crucial for healthcare providers to assess the risk of adverse reactions to certain anesthetic agents and to make informed decisions regarding patient management during anesthesia.
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The dibucaine number test is indicated for the following conditions:
The procedure for obtaining the dibucaine number involves several key steps that ensure accurate measurement of the enzyme activity. First, a qualified healthcare professional performs a venipuncture, which is the process of inserting a needle into a patient's vein to collect a blood sample. This step is crucial as it provides the necessary specimen for testing. Once the blood is drawn, it is collected into a suitable container, typically a tube that is designed to preserve the integrity of the serum or plasma. After collection, the blood sample is processed to separate the serum or plasma from the cellular components. The serum or plasma is then subjected to quantitative enzymatic methodology, which involves specific biochemical reactions that measure the activity of pseudocholinesterase in the presence of dibucaine. The results are expressed as a percentage, indicating the degree of enzyme inhibition caused by dibucaine, thus providing the dibucaine number.
After the dibucaine number test is completed, there are generally no specific post-procedure care requirements for the patient, as the venipuncture is a routine procedure. Patients may experience minor discomfort or bruising at the site of the blood draw, which typically resolves on its own. It is important for healthcare providers to communicate the results of the test to the patient and discuss any implications regarding anesthesia and surgical procedures, especially if a deficiency in pseudocholinesterase is identified. Follow-up may be necessary to ensure that the patient is appropriately managed based on the test results.
| Short Descr | ASSAY OF DIBUCAINE NUMBER | Medium Descr | ASSAY OF DIBUCAINE NUMBER | Long Descr | Dibucaine number | 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. |
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| 2013-01-01 | Changed | Medium Descriptor changed. |
| Pre-1990 | Added | Code added. |
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