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The CPT® Code 84446 refers to a laboratory test that measures the levels of tocopherol alpha, commonly known as Vitamin E, in the blood. Tocopherol alpha is the most bioavailable form of Vitamin E, meaning it is the variant that is most efficiently absorbed and utilized by the body's cells and tissues. This test is crucial for assessing Vitamin E status, as both elevated and decreased levels can have significant health implications. Elevated tocopherol alpha levels may lead to anticoagulant effects, which can increase the risk of bleeding disorders, while decreased levels can result in neuromuscular problems, affecting muscle function and coordination. The test is performed by obtaining a blood sample through a procedure known as venipuncture, which is separately reportable. The analysis of the serum or plasma is conducted using a method called quantitative high-performance liquid chromatography, a precise technique that allows for accurate measurement of Vitamin E levels in the blood.
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The tocopherol alpha (Vitamin E) test is indicated for various clinical scenarios where assessment of Vitamin E levels is necessary. The following conditions may warrant this test:
The procedure for measuring tocopherol alpha levels involves several key steps, ensuring accurate and reliable results. The first step is the collection of a blood sample, which is performed through venipuncture. This involves inserting a needle into a vein, typically in the arm, to draw blood into a collection tube. It is important that this step is performed by a trained healthcare professional to minimize discomfort and ensure the integrity of the sample. Once the blood is collected, it is processed to separate the serum or plasma from the cellular components. The next step involves the analysis of the serum or plasma using quantitative high-performance liquid chromatography (HPLC). This sophisticated technique allows for the precise quantification of tocopherol alpha levels in the sample, providing valuable information regarding the patient's Vitamin E status.
After the blood sample has been collected, there are generally no specific post-procedure care requirements for the patient. However, it is advisable for patients to maintain hydration and avoid strenuous activities immediately following the venipuncture to minimize any potential discomfort or bruising at the site. The results of the tocopherol alpha test will typically be available within a few days, and healthcare providers will discuss the findings with the patient, particularly if any abnormalities are detected that may require further evaluation or intervention.
| Short Descr | ASSAY OF VITAMIN E | Medium Descr | ASSAY OF TOCOPHEROL ALPHA VITAMIN E | Long Descr | Tocopherol alpha (Vitamin E) | 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. | 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 | 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 | 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. | 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. | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GW | Service not related to the hospice patient's terminal condition | GZ | Item or service expected to be denied as not reasonable and necessary | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter |
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| 2015-01-01 | Note | AMA Guidelines removed. |
| 2013-01-01 | Changed | Medium Descriptor changed. |
| Pre-1990 | Added | Code added. |
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