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The CPT® Code 83497 refers to a laboratory test that measures the levels of 5-hydroxyindolacetic acid (5-HIAA) in urine. 5-HIAA is a significant metabolite of serotonin, which is a monoamine neurotransmitter synthesized from the amino acid tryptophan. This test is particularly important in the clinical setting as elevated levels of 5-HIAA can indicate various medical conditions. Specifically, it is often associated with neuroendocrine tumors, particularly those originating in the small intestine, as well as kidney disease or dysfunction. Additionally, conditions such as small bowel resection and autism spectrum disorders may also lead to increased levels of this metabolite. It is crucial to note that certain medications and dietary factors can influence the results of the 5-HIAA test. Drugs that affect serotonin levels, as well as foods that are high in serotonin, should be avoided for a period of 72 hours prior to and during the collection of the urine sample to ensure accurate test results. The urine sample can be collected as a random voided specimen or as a 24-hour collection, and the analysis is typically performed using quantitative high-performance liquid chromatography, a precise method for measuring chemical compounds in biological samples.
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The 5-hydroxyindolacetic acid (5-HIAA) urine test is indicated for the following conditions:
The procedure for collecting a urine sample for the 5-HIAA test involves several key steps to ensure accurate results. First, the patient must be informed about the dietary restrictions that need to be followed prior to the test. Specifically, patients should avoid foods rich in serotonin and any medications that may alter serotonin levels for at least 72 hours before the urine collection. This is crucial as these substances can significantly affect the test outcomes. Next, the urine sample can be collected in two ways: as a random voided specimen or as a 24-hour urine collection. For a random voided specimen, the patient simply provides a urine sample at any time during the day. In contrast, a 24-hour urine collection requires the patient to collect all urine produced over a full 24-hour period, which is then combined into a single container for testing. Once the sample is collected, it is sent to a laboratory where it undergoes analysis using quantitative high-performance liquid chromatography. This sophisticated technique allows for the precise measurement of 5-HIAA levels in the urine, providing valuable information for the diagnosing physician.
After the urine sample has been collected and sent for analysis, there are generally no specific post-procedure care instructions for the patient. However, it is advisable for patients to follow up with their healthcare provider to discuss the results of the test once they are available. The healthcare provider will interpret the results in the context of the patient's overall clinical picture and may recommend further testing or treatment based on the findings. It is also important for patients to resume their normal diet and medications unless otherwise directed by their healthcare provider.
| Short Descr | ASSAY OF 5-HIAA | Medium Descr | ASSAY OF HYDROXYINDOLACETIC ACID 5-HIAA | Long Descr | Hydroxyindolacetic acid, 5-(HIAA) | 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. | 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. | 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. | 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 | 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 | GZ | Item or service expected to be denied as not reasonable and necessary | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | 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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| 2013-01-01 | Changed | Medium Descriptor changed. |
| Pre-1990 | Added | Code added. |
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