CPT® Code 84580

Official Description

Urobilinogen, urine; quantitative, timed specimen

Common Language Description

Urobilinogen is a biochemical compound that results from the reduction of bilirubin, a substance produced during the breakdown of red blood cells. This reduction occurs primarily in the intestines, where bilirubin is converted into urobilinogen. A small portion of urobilinogen is then reabsorbed from the intestines into the bloodstream and subsequently filtered by the kidneys, which is part of a process known as the enterohepatic urobilinogen cycle. The measurement of urobilinogen in urine is significant as it can provide insights into various health conditions. Elevated levels of urobilinogen in urine may indicate several medical issues, including biliary obstruction, hepatic infections, poisoning, or inflammation, as well as hemolytic anemia. Additionally, elevated levels can occur in cases where there is a large hematoma that the body is in the process of absorbing. Conversely, decreased levels of urobilinogen may be observed in conditions such as congenital enzymatic jaundice or when urine acidifying drugs are present. For laboratory evaluations, it is important to distinguish between different types of tests: CPT® Code 84578 is used for qualitative evaluations, CPT® Code 84580 is designated for quantitative assessments of timed specimens, and CPT® Code 84583 is utilized for semiquantitative evaluations.

1. Indications

Urobilinogen testing is indicated for the evaluation of various conditions that may affect liver function or the hemolytic process. The following are specific indications for performing a quantitative urobilinogen test:

Biliary Obstruction Elevated urobilinogen levels may suggest a blockage in the bile ducts, which can impede the normal flow of bile and lead to increased levels of urobilinogen in the urine.
Hepatic Infection Conditions such as hepatitis or other liver infections can disrupt normal liver function, resulting in altered urobilinogen levels.
Poisoning or Inflammation Exposure to certain toxins or inflammatory processes affecting the liver can lead to increased urobilinogen production and excretion.
Hemolytic Anemia In cases of hemolytic anemia, where there is increased breakdown of red blood cells, elevated levels of urobilinogen may be observed due to the increased bilirubin load on the liver.
Large Hematoma Absorption The presence of a significant hematoma that the body is absorbing can also lead to elevated urobilinogen levels in the urine.

2. Procedure

The procedure for obtaining a quantitative urobilinogen test involves several key steps to ensure accurate results. The following outlines the procedural steps:

Step 1: Specimen Collection A timed urine specimen is collected, which is crucial for the quantitative analysis of urobilinogen. The timing of the collection should be specified, as it can affect the concentration of urobilinogen in the urine.
Step 2: Laboratory Processing Once the specimen is collected, it is sent to the laboratory for processing. The urine sample is analyzed using specific biochemical methods to quantify the levels of urobilinogen present.
Step 3: Result Interpretation After analysis, the laboratory will provide a quantitative measurement of urobilinogen in the urine, which will be interpreted in the context of the patient's clinical condition and other laboratory findings.

3. Post-Procedure

Post-procedure care for patients undergoing urobilinogen testing is generally minimal, as the test involves non-invasive urine collection. However, it is important for healthcare providers to communicate the results to the patient and discuss any necessary follow-up actions based on the findings. If elevated or decreased levels of urobilinogen are detected, further diagnostic testing or clinical evaluation may be warranted to determine the underlying cause and appropriate management strategies.

Short Descr	ASSAY OF URINE UROBILINOGEN
Medium Descr	UROBILINOGEN URINE QUANTITATIVE TIMED SPECIMEN
Long Descr	Urobilinogen, urine; quantitative, timed specimen
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