CPT® Code 83919

Official Description

Organic acids; qualitative, each specimen

Common Language Description

The CPT® Code 83919 refers to the qualitative analysis of organic acids, which is performed on each specimen submitted for testing. Organic acids are metabolic by-products that result from the breakdown of proteins and other substances in the body. Under normal circumstances, these organic acids are metabolized into carbon dioxide and water. However, individuals with organic acid disorders experience difficulties in metabolizing certain proteins, leading to a range of health issues, including nutrient deficiencies and potential metabolic crises. These disorders are typically 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 associated with glutaric acidemia type 1 due to the body's inability to properly metabolize lysine and tryptophan), hippuric acid, homogentisic acid, methylhippuric acid, methylmalonic acid (which can indicate a vitamin B12 deficiency), orotic acid, and trichloroacetic acid. Testing can be conducted using either blood or urine specimens, and if blood is the specimen of choice, a separate venipuncture procedure must be reported. The methodology for testing organic acids varies depending on the specimen type and the specific organic acid being analyzed. It is important to note that while CPT® Code 83918 involves a quantitative total analysis of multiple organic acids, providing measurements of their concentrations, CPT® Code 83919 focuses solely on qualitative analysis, determining the presence or absence of organic acids without quantifying their amounts. Each specimen analyzed under this code is reported separately, ensuring accurate documentation and billing for the services rendered.

1. Indications

The qualitative analysis of organic acids, as represented by CPT® Code 83919, is indicated for the evaluation of various metabolic disorders. The following conditions may warrant this testing:

Organic Acid Disorders These are inherited metabolic disorders that can lead to the accumulation of organic acids in the body, resulting in a range of health issues.
Nutrient Deficiencies Testing may be indicated when there is a suspicion of nutrient deficiencies that could be linked to improper metabolism of proteins.
Metabolic Crises Patients experiencing acute metabolic crises may require this analysis to identify underlying organic acid disorders.
Symptoms of Metabolic Dysfunction Symptoms such as developmental delays, failure to thrive, or unexplained neurological issues may prompt testing for organic acids.

2. Procedure

The procedure for conducting a qualitative 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 appropriate specimen, which can be either blood or urine. If blood is collected, a venipuncture must be performed, and this procedure should be reported separately.
Specimen Preparation Once the specimen is collected, it must be properly prepared for analysis. This may involve centrifugation of blood samples to separate plasma or serum, or specific handling protocols for urine samples to ensure the integrity of the organic acids.
Qualitative Analysis The prepared specimen undergoes qualitative testing, which identifies the presence or absence of specific organic acids. This analysis does not quantify the amount of organic acids present but focuses on detecting whether they are present in the specimen.
Reporting Results After the analysis is complete, the results are documented. Each specimen tested is reported separately, ensuring that the findings are clearly communicated for further clinical evaluation and management.

3. Post-Procedure

Post-procedure care following the qualitative analysis of organic acids typically involves monitoring the patient for any immediate reactions, especially if blood was drawn. Patients may be advised to follow up with their healthcare provider to discuss the results of the test and any necessary next steps. Depending on the findings, further diagnostic testing or referrals to specialists may be warranted to address any identified metabolic disorders. It is also important for healthcare providers to consider the clinical context of the test results, as the presence of organic acids can guide treatment decisions and management strategies for the patient.

Short Descr	ORGANIC ACIDS QUAL EACH
Medium Descr	ORGANIC ACIDS QUALITATIVE EACH SPECIMEN
Long Descr	Organic acids; qualitative, 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	1
CCS Clinical Classification	233 - Laboratory - Chemistry and Hematology

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.

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.