CPT® Code 83664

Official Description

Fetal lung maturity assessment; lamellar body density

Common Language Description

A fetal lung maturity assessment is a critical evaluation performed on amniotic fluid to determine the development of the fetus's lungs prior to delivery. This assessment can be conducted using various methods, including the 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 evaluate lung maturity and assess the likelihood of neonatal respiratory distress syndrome (RDS), also known as hyaline membrane disease, occurring after birth. The results of these assessments are vital in guiding clinical decisions regarding the management of premature labor; they help determine whether to attempt to suppress labor or to proceed with delivery based on the maturity of the fetal lungs. Additionally, these tests may be indicated in situations where there are complications affecting the health of the mother and/or fetus, helping to ascertain if the fetal lungs are sufficiently mature to allow for the induction of labor. The lamellar body density assessment specifically involves analyzing the concentration of lamellar bodies, which are responsible for storing surfactant, a substance essential for proper lung function. This assessment is performed on a separately reportable sample of amniotic fluid, with a count of lamellar bodies greater than 30,000 per liter indicating adequate lung maturity.

1. Indications

The fetal lung maturity assessment using lamellar body density (CPT® Code 83664) is indicated for the following conditions:

Evaluation of Lung Maturity - To assess the maturity of the fetal lungs and the likelihood of developing neonatal respiratory distress syndrome (RDS) after delivery.
Management of Premature Labor - To determine whether to suppress premature labor based on the maturity of the fetal lungs.
Induction of Labor - To evaluate if the fetal lungs are mature enough to allow for the induction of labor in cases where there are complications affecting the health of the mother and/or fetus.

2. Procedure

The procedure for assessing fetal lung maturity through lamellar body density involves several key steps:

Sample Collection - A separately reportable sample of amniotic fluid is obtained, typically through an amniocentesis procedure. This sample is crucial for the subsequent analysis of lamellar body density.
Preparation of Amniotic Fluid - A small volume of the collected amniotic fluid, usually less than 1 mL, is prepared for analysis. This minimal volume is sufficient for accurate measurement of lamellar bodies.
Measurement of Lamellar Bodies - The number of lamellar bodies in the amniotic fluid is estimated using light scatter at a specific wavelength or counted using the platelet channel of an automated hematology cell counting instrument. This method allows for precise quantification of lamellar bodies, which are indicative of surfactant presence and lung maturity.
Interpretation of Results - A count greater than 30,000 lamellar bodies per liter is considered indicative of adequate fetal lung maturity, suggesting that the fetus is less likely to experience respiratory distress syndrome after delivery.

3. Post-Procedure

After the lamellar body density assessment, the results are typically reviewed by the healthcare provider to inform clinical decisions regarding the management of the pregnancy. If the count indicates sufficient lung maturity, the healthcare team may proceed with labor and delivery as planned. Conversely, if the count is low, further monitoring and potential interventions may be necessary to manage the risks associated with premature delivery. It is essential for healthcare providers to communicate the results to the patient and discuss any implications for the delivery plan and neonatal care.

Short Descr	LAMELLAR BDY FETAL LUNG
Medium Descr	FETAL LUNG MATURITY LAMELLAR BODY DENSITY
Long Descr	Fetal lung maturity assessment; lamellar body density
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

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.
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.