CPT® Code 82975

Official Description

Glutamine (glutamic acid amide)

Common Language Description

A laboratory test is conducted to assess the concentration of glutamine, also known as glutamic acid amide, which is classified as a non-essential amino acid. Glutamine is a vital component found in high concentrations throughout the body, particularly stored in muscle tissue and present in the bloodstream. The synthesis of glutamine occurs through a biochemical reaction involving glutamate and ammonia, facilitated by the enzyme known as glutamine synthetase. This amino acid plays a crucial role in maintaining the acid-base equilibrium within the kidneys by generating ammonium ions. In situations where glucose is scarce, glutamine serves as an alternative energy source for cells. Additionally, it contributes nitrogen during anabolic processes, such as purine synthesis, and provides carbon for the citric acid cycle, which is essential for cellular respiration. Glutamine is also recognized for its function as a non-toxic transporter of ammonia within the bloodstream. This amino acid is actively utilized by various cells, including those in the intestines and kidneys, as well as by lymphocytes and macrophages, which are integral to the immune response. Furthermore, glutamine is important for the proper functioning of the brain, muscles, and endocrine system. To evaluate glutamine levels, samples from serum, urine, and spinal fluid can be analyzed using advanced techniques such as liquid chromatography-tandem mass spectrometry.

1. Indications

The glutamine level test is performed for various clinical indications, particularly when assessing metabolic and physiological conditions related to amino acid metabolism. The following are specific indications for conducting this laboratory test:

Assessment of metabolic disorders This test may be indicated in patients suspected of having metabolic disorders that affect amino acid levels.
Monitoring of critical illness Glutamine levels can be monitored in critically ill patients, as it plays a significant role in immune function and recovery.
Evaluation of kidney function Since glutamine is involved in acid-base balance, measuring its levels can help evaluate kidney function and metabolic acidosis.
Investigation of gastrointestinal disorders The test may be indicated in patients with gastrointestinal disorders, as glutamine is crucial for intestinal health and function.
Assessment of nutritional status It can be used to assess the nutritional status of patients, particularly those who are malnourished or have undergone significant stress.

2. Procedure

The procedure for measuring glutamine levels involves several key steps, which are outlined below:

Sample Collection Blood, urine, or spinal fluid samples are collected from the patient. For serum testing, venipuncture is performed to obtain a blood sample, while urine samples may be collected as a random or 24-hour specimen. Spinal fluid is obtained through a lumbar puncture if necessary.
Sample Preparation The collected samples are prepared for analysis. This may involve centrifugation of blood samples to separate serum from cellular components, as well as appropriate handling and storage of urine and spinal fluid samples to maintain their integrity.
Analytical Method The prepared samples are analyzed using liquid chromatography-tandem mass spectrometry (LC-MS/MS). This advanced technique allows for the precise quantification of glutamine levels in the samples, providing accurate results.
Result Interpretation Once the analysis is complete, the results are interpreted by qualified laboratory personnel. The glutamine levels are compared against established reference ranges to determine if they are within normal limits or indicative of a potential metabolic issue.

3. Post-Procedure

After the glutamine level test is completed, there are generally no specific post-procedure care requirements for patients. However, it is essential to monitor the patient for any adverse reactions if blood samples were collected. Patients should be informed about when to expect their results and any necessary follow-up appointments to discuss the findings with their healthcare provider. If the test results indicate abnormal glutamine levels, further evaluation or additional testing may be warranted to determine the underlying cause and appropriate management strategies.

Short Descr	ASSAY OF GLUTAMINE
Medium Descr	ASSAY OF GLUTAMINE
Long Descr	Glutamine (glutamic acid amide)
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	233 - Laboratory - Chemistry and Hematology