CPT® Code 83918

Official Description

Organic acids; total, quantitative, each specimen

Common Language Description

The CPT® Code 83918 refers to the quantitative analysis of organic acids in a specimen, which can be either blood or urine. Organic acids are metabolic by-products that are typically broken down into carbon dioxide and water during normal metabolic processes. However, in individuals with organic acid disorders, certain proteins fail to undergo proper breakdown, leading to various health complications, including nutrient deficiencies and metabolic crises. These disorders are inherited in an autosomal recessive manner, affecting both males and females equally. The symptoms associated with organic acid disorders can vary significantly based on the specific type of disorder present, and treatment approaches are tailored accordingly. Common organic acids that may be tested include 2,4 dichlorophenoxyacetic acid, formic acid, glutaric acid (which is indicative of glutaric acidemia type 1, a condition resulting from the inability to metabolize lysine and tryptophan), hippuric acid, homogentisic acid, methylhippuric acid, methylmalonic acid (which can indicate a vitamin B12 deficiency), orotic acid, and trichloroacetic acid. The testing methodology employed is contingent upon both the specimen type and the specific organic acid being analyzed. Under CPT® Code 83918, a comprehensive quantitative analysis of multiple organic acids is conducted, measuring their concentrations in the specimen. Each specimen analyzed is reported separately, allowing for detailed assessment. This code is distinct from CPT® Code 83919, which pertains to qualitative analysis that determines the presence or absence of organic acids without quantifying their amounts, and CPT® Code 83921, which focuses on the quantitative measurement of a single organic acid.

1. Indications

The analysis of organic acids is indicated for various metabolic disorders and conditions that may arise from the improper breakdown of proteins. The following are specific indications for performing this test:

Organic Acid Disorders These are inherited metabolic disorders that can lead to a range of health issues due to the accumulation of organic acids in the body.
Nutrient Deficiencies Testing may be indicated when there is a suspicion of nutrient deficiencies that could be linked to metabolic dysfunctions.
Metabolic Crises The test is often performed during metabolic crises to identify the underlying cause related to organic acid accumulation.
Monitoring Treatment Organic acid testing can be used to monitor the effectiveness of treatment in patients diagnosed with organic acid disorders.

2. Procedure

The procedure for conducting a quantitative analysis of organic acids involves several key steps, which are outlined below:

Specimen Collection The first step in the procedure is the collection of the specimen, which can be either blood or urine. If blood is the chosen specimen type, a venipuncture is performed to obtain the sample. It is essential to follow proper protocols for specimen collection to ensure accurate results.
Specimen Preparation Once the specimen is collected, it must be prepared for analysis. This may involve processing the sample to isolate the organic acids present. The specific preparation steps can vary depending on the type of specimen and the organic acids being tested.
Quantitative Analysis The prepared specimen undergoes a quantitative analysis, where the concentration of multiple organic acids is measured. This analysis is performed using methodologies that are appropriate for the specific organic acids and specimen type. The results provide a detailed account of the levels of organic acids present in the specimen.
Reporting Results After the analysis is complete, the results are compiled and reported. Each specimen tested is reported separately, allowing for a clear understanding of the organic acid levels in each sample.

3. Post-Procedure

Post-procedure care primarily involves the handling of the specimen and the interpretation of results. After the analysis, healthcare providers should review the results in conjunction with clinical findings to determine the appropriate course of action. If blood was collected, patients may experience minor discomfort or bruising at the venipuncture site, which typically resolves quickly. It is important for healthcare professionals to communicate the results to the patient and discuss any necessary follow-up actions or treatments based on the findings of the organic acid analysis.

Short Descr	ORGANIC ACIDS TOTAL QUANT
Medium Descr	ORGANIC ACIDS TOTAL QUANTITATIVE EACH SPECIMEN
Long Descr	Organic acids; total, quantitative, each specimen
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.