CPT® Code 83068

Official Description

Hemoglobin; unstable, screen

Common Language Description

The CPT® Code 83068 refers to a laboratory test specifically designed to screen for unstable hemoglobin. This blood test is crucial for identifying hemoglobin molecules that are unstable due to genetic mutations affecting the globin gene. Unstable hemoglobin is typically associated with a rare genetic disorder that is usually inherited in an autosomal dominant manner. This condition leads to changes in the solubility of hemoglobin, primarily due to the oxidation of amino acid residues within the globin chains. The screening is particularly indicated when a patient presents with unexplained hemolytic anemia, and it is essential to rule out other hemolytic disorders, such as sickle cell disease, fetal hemoglobin disorders, and methemoglobinemia, before proceeding with this test. It is important to note that test results for infants aged six months and younger may not be reliable, which can affect the interpretation of the findings. The procedure involves obtaining a blood sample through venipuncture, which is separately reportable, and the analysis is conducted on whole blood using visual methods to identify hemoglobin precipitates.

1. Indications

The CPT® Code 83068 is indicated for use in specific clinical scenarios where there is a suspicion of unstable hemoglobin. The following conditions warrant the performance of this screening test:

Unexplained Hemolytic Anemia - This test is performed when a patient presents with hemolytic anemia that cannot be explained by other common causes.
Ruling Out Other Hemolytic Disorders - Prior to conducting this test, it is essential to exclude other hemolytic conditions such as sickle hemoglobin disorders, fetal hemoglobin disorders, and methemoglobinemia.

2. Procedure

The procedure for performing the hemoglobin unstable screening involves several key steps that ensure accurate results. First, a blood sample is obtained from the patient through a process known as venipuncture. This step is critical as it provides the necessary whole blood sample for testing. The venipuncture must be reported separately, as it is a distinct procedure. Once the blood sample is collected, it is subjected to testing where the whole blood is analyzed for the presence of unstable hemoglobin. The testing method involves visual identification of hemoglobin precipitates, which are indicative of instability in the hemoglobin molecules. This visual assessment is crucial for determining the presence of any genetic mutations affecting the globin gene that may lead to unstable hemoglobin.

3. Post-Procedure

After the hemoglobin unstable screening is completed, the results will be interpreted by a qualified healthcare professional. It is important to consider that test results for infants aged six months and younger may be unreliable, which could necessitate further testing or alternative diagnostic approaches. Depending on the findings, additional follow-up may be required to confirm the diagnosis or to explore other potential causes of hemolytic anemia. Healthcare providers should ensure that patients are informed about the implications of the test results and any subsequent steps that may be necessary for management or treatment.

Short Descr	HEMOGLOBIN UNSTABLE SCREEN
Medium Descr	HEMOGLOBIN UNSTABLE SCREEN
Long Descr	Hemoglobin; unstable, screen
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

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.

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.