CPT® Code 83951

Official Description

Oncoprotein; des-gamma-carboxy-prothrombin (DCP)

Common Language Description

The CPT® Code 83951 refers to the laboratory test for the oncoprotein known as des-gamma-carboxy-prothrombin (DCP). This test is performed on a blood sample obtained through a procedure called venipuncture, which is a method of drawing blood from a vein. DCP is classified as an oncoprotein, which means it is a protein that is associated with cancer and is encoded by an oncogene. Oncoproteins play a crucial role in regulating cell growth and division; however, their presence in elevated levels can signal a malignant process, indicating potential cancer development. Specifically, in patients suffering from chronic liver disease, increased levels of DCP can suggest a heightened risk for hepatocellular carcinoma, a common type of liver cancer. During the testing process, the blood serum is treated with two specific labeled monoclonal antibodies: one targets prothrombin, while the other specifically binds to DCP. This dual antibody approach allows for the precise identification and measurement of DCP levels. To isolate the DCP from prothrombin and any unbound enzyme-labeled antibodies, anion exchange chromatography is employed. This technique separates molecules based on their charge, ensuring that the DCP can be accurately quantified. The measurement of DCP concentration is conducted by assessing the peroxidase enzyme activity through fluorescence detection. Finally, the concentration of DCP is calculated using established calibrators and is reported in nanograms per milliliter, providing a quantitative assessment of the oncoprotein's presence in the serum.

1. Indications

The test for des-gamma-carboxy-prothrombin (DCP) is indicated for the following conditions:

Chronic Liver Disease Elevated levels of DCP may indicate an increased risk for the development of hepatocellular carcinoma in patients with chronic liver conditions.

2. Procedure

The procedure for testing des-gamma-carboxy-prothrombin (DCP) involves several key steps to ensure accurate measurement of the oncoprotein in the blood serum.

Step 1: Blood Sample Collection A blood sample is obtained from the patient through a venipuncture, which is the process of puncturing a vein to draw blood. This sample is essential for the subsequent analysis of DCP levels.
Step 2: Serum Preparation Once the blood sample is collected, it is processed to separate the serum from the cellular components. This serum is the portion of the blood that will be analyzed for the presence of DCP.
Step 3: Application of Monoclonal Antibodies The serum is then exposed to two labeled monoclonal antibodies: one that targets prothrombin and another that specifically binds to DCP. This step is crucial for the selective identification of DCP in the serum.
Step 4: Anion Exchange Chromatography Anion exchange chromatography is employed to separate the DCP from prothrombin and any unbound enzyme-labeled antibodies. This technique utilizes the charge properties of the molecules to achieve separation, allowing for a more accurate measurement of DCP.
Step 5: Measurement of Enzyme Activity The peroxidase enzyme activity is then measured using fluorescence detection. This measurement is indicative of the presence and concentration of DCP in the serum.
Step 6: Calculation and Reporting Finally, the concentration of DCP is calculated using calibrators, and the results are reported in nanograms per milliliter, providing a quantitative assessment of the oncoprotein levels in the patient's serum.

3. Post-Procedure

After the procedure, there are no specific post-procedure care requirements mentioned for the DCP test. However, it is important for healthcare providers to monitor the patient for any potential adverse reactions to the venipuncture, such as bruising or discomfort at the site of blood draw. The results of the DCP test should be interpreted in conjunction with other clinical findings and diagnostic tests to assess the patient's risk for hepatocellular carcinoma and to guide further management.

Short Descr	ONCOPROTEIN DCP
Medium Descr	ONCOPROTEIN DES-GAMMA-CARBOXY-PROTHROMBIN DCP
Long Descr	Oncoprotein; des-gamma-carboxy-prothrombin (DCP)
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

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.

Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.