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The CPT® Code 84134 refers to a laboratory test that measures the levels of prealbumin in the blood. Prealbumin, also known as transthyretin (TTR), is a protein that plays a crucial role in the transport of thyroxin, a hormone produced by the thyroid gland, and retinol binding protein, which carries vitamin A (retinol) in the bloodstream. This test is particularly significant in clinical settings as it helps assess nutritional status, especially in patients who are chronically or critically ill. The measurement of prealbumin levels can provide valuable insights into protein-calorie malnutrition, which is a common concern in these populations. The test is performed on a blood sample, which is typically obtained through a procedure known as venipuncture. This involves puncturing a vein to collect blood for analysis. The serum or plasma obtained from the blood sample is then tested using an immunoturbidimetric method, a laboratory technique that quantifies the concentration of proteins in the sample. Prealbumin levels can vary based on several factors. Elevated levels may occur due to the use of high-dose corticosteroids or non-steroidal anti-inflammatory drugs (NSAIDs), as well as in conditions such as adrenal gland disorders, Hodgkin's disease, and kidney failure. Conversely, decreased prealbumin levels can indicate various health issues, including hyperthyroidism, liver disease, severe infections, inflammatory diseases, and certain digestive disorders. Understanding these levels is essential for healthcare providers in diagnosing and managing patients' nutritional and health status.
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The prealbumin test (CPT® Code 84134) is indicated for several clinical scenarios, particularly in assessing nutritional status and identifying potential health issues. The following conditions may warrant the ordering of this test:
The procedure for obtaining a prealbumin test involves several key steps that ensure accurate measurement of prealbumin levels in the blood. The following outlines the procedural steps:
After the prealbumin test is completed, there are several considerations for post-procedure care. Patients may experience minor discomfort or bruising at the venipuncture site, which typically resolves on its own. It is advisable for patients to apply pressure to the site for a few minutes to minimize bleeding and reduce the risk of bruising. Results from the prealbumin test are usually available within a short timeframe, allowing healthcare providers to quickly assess the patient's nutritional status and make necessary adjustments to their treatment plan. Depending on the results, further evaluation or additional tests may be warranted to address any underlying health issues. Patients should be informed about when to expect their results and any follow-up appointments that may be necessary to discuss the findings and implications for their health.
| Short Descr | ASSAY OF PREALBUMIN | Medium Descr | PREALBUMIN | Long Descr | Prealbumin | 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. | GW | Service not related to the hospice patient's terminal condition | 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. | GA | Waiver of liability statement issued as required by payer policy, individual case | GZ | Item or service expected to be denied as not reasonable and necessary | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | 59 | 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. | 77 | 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. | 91 | Repeat clinical diagnostic laboratory test: in the course of treatment of the patient, it may be necessary to repeat the same laboratory test on the same day to obtain subsequent (multiple) test results. under these circumstances, the laboratory test performed can be identified by its usual procedure number and the addition of modifier 91. note: this modifier may not be used when tests are rerun to confirm initial results; due to testing problems with specimens or equipment; or for any other reason when a normal, one-time, reportable result is all that is required. this modifier may not be used when other code(s) describe a series of test results (eg, glucose tolerance tests, evocative/suppression testing). this modifier may only be used for laboratory test(s) performed more than once on the same day on the same patient. | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | AY | Item or service furnished to an esrd patient that is not for the treatment of esrd | GC | This service has been performed in part by a resident under the direction of a teaching physician | GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | QW | Clia waived test | X5 | Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter |
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| 1993-01-01 | Added | First appearance in code book in 1993. |
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