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The CPT® Code 84146 refers to a laboratory test specifically designed to measure the levels of prolactin in the blood. Prolactin is a hormone that is primarily produced by the pituitary gland, which is located at the base of the brain. This hormone plays a crucial role in various bodily functions, particularly in regulating lactation, as it stimulates breast milk production in women during and after pregnancy. It is important to note that prolactin levels can fluctuate naturally throughout the day and night, reflecting the body's circadian rhythms. Additionally, certain physiological conditions can lead to normal elevations in prolactin levels, such as during pregnancy, lactation, or periods of physical or emotional stress. Abnormal elevations in prolactin levels may indicate underlying health issues, including kidney and liver diseases, hypothyroidism, and the presence of tumors in the pituitary gland, known as prolactinomas. Conversely, decreased prolactin levels may suggest damage to the pituitary gland itself. The prolactin test is often ordered in clinical settings to investigate various symptoms, including nipple discharge, infertility in both men and women, and erectile dysfunction in men. Furthermore, this code can also be utilized to report specific tests related to prolactin-secreting tumors, such as prolactin macroadenoma (dilution study), and thyroid releasing hormone stimulation of prolactin, which involves measuring prolactin levels at multiple time intervals (0, 30, 60, and 90 minutes). The blood sample required for this test is obtained through a procedure known as venipuncture, which is separately reportable. The serum or plasma obtained from the blood sample is then analyzed using a quantitative chemiluminescent immunoassay, a sensitive and specific method for measuring hormone levels in the laboratory.
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The prolactin test (CPT® Code 84146) is indicated for several clinical scenarios where abnormal prolactin levels may be suspected or need to be evaluated. The following conditions and symptoms may warrant the ordering of this test:
The procedure for obtaining a prolactin level involves several key steps that ensure accurate measurement of the hormone in the blood. The following procedural steps are typically followed:
After the blood sample has been collected and sent for analysis, there are generally no specific post-procedure care instructions for the patient. However, patients may be advised to resume normal activities unless otherwise directed by their healthcare provider. The results of the prolactin test will typically be available within a few days, and the healthcare provider will discuss the findings with the patient, including any necessary follow-up actions based on the results. If elevated prolactin levels are detected, further evaluation may be required to determine the underlying cause and appropriate management strategies.
| Short Descr | ASSAY OF PROLACTIN | Medium Descr | ASSAY OF PROLACTIN | Long Descr | Prolactin | 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 | 3 | 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. | 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. | 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. | GA | Waiver of liability statement issued as required by payer policy, individual case | Q4 | Service for ordering/referring physician qualifies as a service exemption | GW | Service not related to the hospice patient's terminal condition | 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 | 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 | 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 | 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. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 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. | 95 | Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system. | AY | Item or service furnished to an esrd patient that is not for the treatment of esrd | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | PO | Excepted service provided at an off-campus, outpatient, provider-based department of a hospital | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | SA | Nurse practitioner rendering service in collaboration with a physician | X1 | Continuous/broad services: for reporting services by clinicians, who provide the principal care for a patient, with no planned endpoint of the relationship; services in this category represent comprehensive care, dealing with the entire scope of patient problems, either directly or in a care coordination role; reporting clinician service examples include, but are not limited to: primary care, and clinicians providing comprehensive care to patients in addition to specialty care | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2013-01-01 | Changed | Medium Descriptor changed. |
| Pre-1990 | Added | Code added. |
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