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The CPT® Code 83021 refers to a laboratory procedure known as hemoglobin fractionation and quantitation, specifically utilizing chromatography techniques to analyze hemoglobin variants present in red blood cells (RBCs). Hemoglobin is a crucial protein found in RBCs, responsible for the transport of oxygen throughout the body. In adults, the predominant form of hemoglobin is known as hemoglobin A (HbA), which consists of two alpha and two beta chains. Variants of hemoglobin can occur due to genetic mutations, leading to different types of hemoglobin, such as HbA2, HbC, HbF, and HbS. Each of these variants has distinct structural characteristics and clinical implications. For instance, HbA2, which contains two delta chains instead of beta chains, may indicate the presence of delta thalassemia. HbC is an abnormal variant that can lead to mild hemolytic anemia when present in a homozygous state. HbF, or fetal hemoglobin, is composed of two alpha and two gamma chains and is typically found in fetuses and infants, playing a vital role in oxygen transport during development. The presence of HbS, resulting from a mutation that substitutes valine for glutamic acid in the beta chain, is associated with sickle cell disease. The procedure involves obtaining a blood sample through venipuncture, which is then analyzed using high-performance liquid chromatography to accurately identify and quantify these hemoglobin variants, providing essential information for diagnosis and management of various hematological conditions.
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The hemoglobin fractionation and quantitation procedure (CPT® Code 83021) is indicated for the evaluation of various hematological conditions and to identify specific hemoglobin variants. The following conditions may warrant this testing:
The hemoglobin fractionation and quantitation procedure involves several key steps to ensure accurate analysis of hemoglobin variants. The following procedural steps are typically followed:
After the hemoglobin fractionation and quantitation procedure, the patient may not require any specific post-procedure care, as the blood sample collection is minimally invasive. However, it is important for healthcare providers to review the results of the test with the patient, discussing any findings related to hemoglobin variants and their implications for health. Follow-up appointments may be necessary to address any identified conditions, such as hemoglobinopathies or anemia, and to develop an appropriate management plan based on the test results.
| Short Descr | HEMOGLOBIN CHROMOTOGRAPHY | Medium Descr | HEMOGLOBIN FRACTJ/QUANTJ CHROMOTOGRAPHY | Long Descr | Hemoglobin fractionation and quantitation; chromatography (eg, A2, S, C, and/or F) | 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. | GA | Waiver of liability statement issued as required by payer policy, individual case | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | 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. | 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. | 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. | GW | Service not related to the hospice patient's terminal condition | Q4 | Service for ordering/referring physician qualifies as a service exemption | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2001-01-01 | Changed | Code description changed. |
| 1999-01-01 | Added | First appearance in code book in 1999. |
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