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The Xylose absorption test, identified by CPT® Code 84620, is a diagnostic procedure that evaluates the absorption capacity of carbohydrates from the proximal small intestine. This test involves the analysis of both blood and urine samples to measure the levels of xylose, a simple sugar that is absorbed in the intestines. The procedure begins with the patient fasting, followed by the collection of a fasting serum sample. Subsequently, a dose of xylose, either 5 grams or 25 grams, is administered to the patient, with the specific dosage determined by the patient's weight, particularly in pediatric cases. After the administration of xylose, a second serum sample is collected two hours later, and urine is collected for a duration of five hours post-dose. The results of this test can indicate malabsorption syndromes, which may include conditions such as celiac disease, Crohn's disease, Whipple disease, intestinal inflammatory disorders, short bowel syndrome, and parasitic infections like giardia and hookworm. The blood sample is obtained through a venipuncture, which is a separately reportable procedure, while urine collection is conducted via normal voiding. The analysis of both serum and urine samples is performed using quantitative spectrophotometry, a method that quantifies the concentration of substances in the samples.
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The Xylose absorption test is indicated for the evaluation of carbohydrate absorption from the proximal small intestine. It is particularly useful in diagnosing various malabsorption syndromes and intestinal disorders. The following conditions may warrant the use of this test:
The Xylose absorption test involves several key procedural steps to ensure accurate measurement of xylose absorption. The procedure is as follows:
After the completion of the Xylose absorption test, the patient may resume normal activities. There are typically no specific post-procedure care instructions required, as the test is non-invasive and does not involve any significant recovery time. However, it is important for the healthcare provider to review the results of the serum and urine tests to determine if further diagnostic evaluation or treatment is necessary based on the findings. The results can help in diagnosing potential malabsorption issues and guiding subsequent management strategies.
| Short Descr | XYLOSE TOLERANCE TEST | Medium Descr | XYLOSE ABSORPTION TEST BLOOD &/URINE | Long Descr | Xylose absorption test, blood and/or urine | 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 |
| 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. | 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. | 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. |
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| Pre-1990 | Added | Code added. |
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