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The CPT® Code 84449 refers to a laboratory test that measures the levels of transcortin, also known as cortisol binding globulin (CBG), in the blood. Transcortin is a type of alpha globulin protein that plays a crucial role in binding steroid hormones, including cortisol, progesterone, aldosterone, and 11-Deoxycorticosteroid. This binding is essential for the regulation and transport of these hormones throughout the body. Transcortin is synthesized in the liver, and its production is influenced by estrogen levels, which can lead to normal physiological increases during pregnancy. Conversely, decreased levels of transcortin may indicate underlying health issues, particularly liver disorders such as cirrhosis, which can impair the liver's ability to produce this protein. The test is performed by obtaining a blood sample through venipuncture, which is a procedure that can be reported separately. The serum obtained from the blood sample is then analyzed using a method known as radioimmunoassay, a sensitive technique that allows for the precise measurement of hormone levels in the serum.
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The transcortin (cortisol binding globulin) test, represented by CPT® Code 84449, is indicated for the evaluation of various clinical conditions related to steroid hormone levels. The following are specific indications for performing this test:
The procedure for obtaining the transcortin (cortisol binding globulin) test involves several key steps, which are outlined below:
After the transcortin test is completed, the patient may be monitored briefly to ensure there are no immediate complications from the venipuncture, such as excessive bleeding or discomfort. The results of the test will be analyzed and reported to the healthcare provider, who will interpret the findings in the context of the patient's overall health and any symptoms they may be experiencing. Depending on the results, further testing or follow-up may be necessary to address any identified hormonal imbalances or liver function issues.
| Short Descr | ASSAY OF TRANSCORTIN | Medium Descr | ASSAY OF TRANSCORTIN CORTISOL BINDING GLOBULIN | Long Descr | Transcortin (cortisol binding globulin) | 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. | 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. | GA | Waiver of liability statement issued as required by payer policy, individual case |
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| 2013-01-01 | Changed | Medium Descriptor changed. |
| 1994-01-01 | Added | First appearance in code book in 1994. |
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