CPT® Code 83663

Official Description

Fetal lung maturity assessment; fluorescence polarization

Common Language Description

A fetal lung maturity assessment is a critical procedure performed to evaluate the development of the fetus's lungs prior to delivery. This assessment can be conducted using three different methods: foam stability test (CPT® Code 83662), fluorescence polarization (CPT® Code 83663), and lamellar body density (CPT® Code 83664). The primary purpose of these tests is to analyze amniotic fluid, which provides essential information regarding the likelihood of neonatal respiratory distress syndrome (RDS), also known as hyaline membrane disease, occurring after birth. By assessing lung maturity, healthcare providers can make informed decisions about whether to intervene in cases of premature labor or to allow the delivery to proceed based on the maturity of the fetal lungs. Additionally, these assessments are crucial in situations where the health of the mother or fetus is compromised, as they help determine if the lungs are sufficiently mature to safely induce labor. The fluorescence polarization method, specifically associated with CPT® Code 83663, utilizes an automated fluorescence polarimeter to measure the concentration of specific lipids in the amniotic fluid, providing a quantitative assessment of lung maturity.

1. Indications

The fetal lung maturity assessment using fluorescence polarization (CPT® Code 83663) is indicated in the following scenarios:

Evaluation of Lung Maturity This test is performed to assess the maturity of the fetal lungs, which is crucial for determining the risk of neonatal respiratory distress syndrome (RDS) after delivery.
Management of Premature Labor The assessment helps decide whether to suppress premature labor based on the maturity of the fetal lungs.
Induction of Labor It is indicated to determine if the fetal lungs are mature enough to allow for the safe induction of labor in cases where the mother or fetus has health complications.

2. Procedure

The procedure for conducting a fetal lung maturity assessment using fluorescence polarization involves several key steps:

Sample Collection A separately reportable sample of amniotic fluid is obtained from the patient. This sample is essential for the subsequent analysis of lung maturity.
Preparation of the Sample The collected amniotic fluid is prepared for testing. This involves ensuring that the sample is suitable for analysis and free from contamination.
Fluorescence Polarization Testing The prepared amniotic fluid sample is analyzed using an automated fluorescence polarimeter. This device measures the fluorescence polarization of complex lipid molecules, specifically lecithin and sphingomyelin, when exposed to ultraviolet light.
Data Interpretation The results are interpreted by determining the relative concentration of lecithin and sphingomyelin in the amniotic fluid. Additionally, the surfactant to albumin ratio (SAR) is calculated. A SAR of 50-70 mg of surfactant per gram of albumin indicates adequate lung maturity.

3. Post-Procedure

After the fetal lung maturity assessment using fluorescence polarization, the results are typically reviewed by the healthcare provider to make informed clinical decisions. Depending on the findings, the provider may discuss the implications of the results with the patient, including the potential need for interventions related to labor and delivery. It is important to monitor the patient for any signs of complications and to provide appropriate follow-up care based on the assessment outcomes.

Short Descr	FLUORO POLARIZE FETAL LUNG
Medium Descr	FETAL LUNG MATURITY FLUORESCENCE POLARIZATION
Long Descr	Fetal lung maturity assessment; fluorescence polarization
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	3
CCS Clinical Classification	233 - Laboratory - Chemistry and Hematology