CPT® Code 84120

Official Description

Porphyrins, urine; quantitation and fractionation

Common Language Description

The CPT® Code 84120 refers to a laboratory test that quantifies and fractionates porphyrins in urine. Porphyrins are organic compounds that play a crucial role in the formation of heme, which is an essential component of hemoglobin in red blood cells and myoglobin in muscle cells. This test is significant for diagnosing various medical conditions, as elevated porphyrin levels can indicate potential health issues such as lead poisoning, liver disease, or porphyria, which is a genetic disorder characterized by a deficiency of enzymes involved in the heme synthesis pathway. The procedure typically involves collecting a 24-hour urine sample, although a random urine sample may be utilized during acute symptomatic episodes. The analysis is performed using quantitative high-performance liquid chromatography, a sophisticated technique that allows for precise measurement of porphyrin levels in the urine. This test is often ordered alongside other tests, such as the urine porphobilinogen test (CPT® Code 84106), to provide a comprehensive assessment of porphyrin metabolism and related disorders.

1. Indications

The urine porphyrins quantitation and fractionation test (CPT® Code 84120) is indicated for the evaluation of various medical conditions associated with abnormal porphyrin metabolism. The following conditions may warrant this test:

Lead Poisoning Elevated porphyrin levels can be indicative of lead toxicity, which can affect multiple organ systems.
Liver Disease Conditions affecting liver function may lead to altered porphyrin metabolism, necessitating this test for diagnosis.
Porphyria This inherited metabolic disorder is characterized by enzyme deficiencies in the heme synthesis pathway, leading to the accumulation of porphyrins.

2. Procedure

The procedure for conducting the urine porphyrins quantitation and fractionation test involves several key steps to ensure accurate results. First, a 24-hour urine collection is initiated, where the patient is instructed to collect all urine produced over a 24-hour period. This comprehensive collection is crucial as it provides a complete picture of porphyrin levels in the body. In some cases, particularly during acute symptomatic episodes, a random urine sample may be collected instead. Once the urine sample is obtained, it is sent to a laboratory for analysis. The laboratory employs quantitative high-performance liquid chromatography, a sophisticated analytical technique that separates and quantifies the various porphyrins present in the urine. This method allows for precise measurement of porphyrin levels, which is essential for diagnosing the aforementioned conditions.

3. Post-Procedure

After the urine porphyrins quantitation and fractionation test is completed, the patient may resume normal activities without any specific restrictions. There are typically no significant post-procedure care requirements, as the test is non-invasive and does not involve any surgical intervention. However, it is important for healthcare providers to discuss the results with the patient once they are available, as elevated porphyrin levels may necessitate further diagnostic evaluation or management of underlying conditions. Patients should be informed about the significance of the test results and any potential follow-up actions that may be required based on the findings.

Short Descr	ASSAY OF URINE PORPHYRINS
Medium Descr	PORPHYRINS URINE QUANTITATION & FRACTIONATION
Long Descr	Porphyrins, urine; quantitation and fractionation
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

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.
GZ	Item or service expected to be denied as not reasonable and necessary