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The CPT® Code 83615 refers to the laboratory test for measuring lactate dehydrogenase (LD) levels, also known as lactate dehydrogenase (LDH). This enzyme is found in various tissues throughout the body, including red blood cells (RBCs), heart, liver, pancreas, kidneys, skeletal muscle, brain, and lungs. The measurement of LDH levels is significant as it serves as a biomarker for tissue and RBC damage. Elevated levels of LDH in the blood can indicate a range of medical conditions, including stroke, myocardial infarction (heart attack), liver disease, pancreatitis, muscular dystrophy, infectious mononucleosis, hemolytic anemia, and certain tumors or cancers, such as lymphoma. Additionally, increased levels of LDH in cerebral spinal fluid (CSF) are typically associated with bacterial meningitis. In the context of pleural and pericardial fluids, LDH levels can help differentiate between exudative effusions, which are often due to infections, and transudative effusions, which are generally caused by fluid pressure issues. The test requires a blood sample, which is obtained through a venipuncture, and may also involve the collection of other body fluids such as CSF, pericardial fluid, or pleural fluid, each of which must be reported separately using appropriate codes for the procedures performed. The analysis of serum, plasma, and all body fluids is conducted using quantitative enzymatic methodology to ensure accurate measurement of LDH levels.
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The lactate dehydrogenase (LDH) test, represented by CPT® Code 83615, is indicated for various clinical scenarios where tissue or red blood cell damage is suspected. The following conditions may warrant the performance of this test:
The procedure for obtaining lactate dehydrogenase (LDH) levels involves several steps, each critical for accurate testing and diagnosis. The first step is the collection of a blood sample, which is performed through a venipuncture. This procedure involves inserting a needle into a vein, typically in the arm, to draw blood into a collection tube. It is essential that this step is conducted using sterile techniques to prevent contamination and ensure the integrity of the sample.
In addition to blood samples, LDH levels can also be measured in various body fluids. For instance, cerebral spinal fluid (CSF) is obtained through a lumbar puncture, commonly referred to as a spinal tap. This procedure involves inserting a needle into the lower back to collect CSF, which is then analyzed for LDH levels. Similarly, pericardial fluid can be collected via pericardiocentesis, a procedure that involves inserting a needle into the pericardial space around the heart to withdraw fluid. Lastly, fluid from a pleural effusion is obtained through thoracentesis, where a needle is inserted into the pleural space to collect fluid for analysis. Each of these fluid collection procedures must be reported separately, as they are distinct from the blood sample collection.
Once the samples are collected, they are subjected to testing using quantitative enzymatic methodology. This method ensures that the LDH levels are measured accurately, providing valuable information for diagnosing and managing the underlying conditions associated with elevated LDH levels.
After the collection of blood or body fluid samples for LDH testing, there are specific post-procedure considerations to keep in mind. For blood samples, patients may experience minor discomfort or bruising at the venipuncture site, which typically resolves on its own. It is advisable for patients to apply pressure to the site after the needle is removed to minimize bleeding and promote healing.
In the case of lumbar puncture, patients may experience headache or back discomfort following the procedure. Adequate hydration and rest are recommended to alleviate these symptoms. For procedures like pericardiocentesis and thoracentesis, monitoring for any complications such as infection, bleeding, or pneumothorax is essential. Patients should be informed about signs of potential complications and advised to seek medical attention if they experience any concerning symptoms post-procedure.
Overall, the results of the LDH test will be interpreted in conjunction with clinical findings and other diagnostic tests to provide a comprehensive assessment of the patient's condition.
| Short Descr | LACTATE (LD) (LDH) ENZYME | Medium Descr | LACTATE DEHYDROGENASE LDH | Long Descr | Lactate dehydrogenase (LD), (LDH); | 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. | 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 | 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. | 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 | GW | Service not related to the hospice patient's terminal condition | GA | Waiver of liability statement issued as required by payer policy, individual case | 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. | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | GZ | Item or service expected to be denied as not reasonable and necessary | Q0 | Investigational clinical service provided in a clinical research study that is in an approved clinical research study | PD | Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | AY | Item or service furnished to an esrd patient that is not for the treatment of esrd | CR | Catastrophe/disaster related | FS | Split (or shared) evaluation and management visit | GC | This service has been performed in part by a resident under the direction of a teaching physician | GX | Notice of liability issued, voluntary under payer policy | KX | Requirements specified in the medical policy have been met | PN | Non-excepted service provided at an off-campus, outpatient, provider-based department of a hospital | PO | Excepted service provided at an off-campus, outpatient, provider-based department of a hospital | QP | Documentation is on file showing that the laboratory test(s) was ordered individually or ordered as a cpt-recognized panel other than automated profile codes 80002-80019, g0058, g0059, and g0060. | SA | Nurse practitioner rendering service in collaboration with a physician | TR | School-based individualized education program (iep) services provided outside the public school district responsible for the student | X2 | Continuous/focused services: for reporting services by clinicians whose expertise is needed for the ongoing management of a chronic disease or a condition that needs to be managed and followed with no planned endpoint to the relationship; reporting clinician service examples include but are not limited to: a rheumatologist taking care of the patient's rheumatoid arthritis longitudinally but not providing general primary care services | X5 | Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | 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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| 2010-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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