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The gliadin (deamidated) (DGP) antibody test, identified by CPT® Code 86258, is a laboratory test utilized to assess the presence of antibodies associated with celiac disease, also referred to as celiac sprue. Celiac disease is an autoimmune disorder triggered by an abnormal immune response to gluten, a protein found in wheat, barley, rye, and oats. This immune response leads to the production of autoantibodies that can damage the small intestine's villi, which are tiny, finger-like projections that play a crucial role in nutrient absorption. Gliadin, a significant component of gluten, is specifically targeted in this test. The symptoms of celiac disease can vary widely but often include recurring abdominal pain, bloating, and gastrointestinal disturbances such as chronic diarrhea or constipation, which may present with pale and foul-smelling stools. Additionally, individuals may experience weight loss and iron deficiency anemia due to malabsorption of nutrients. The DGP test primarily measures IgA antibodies (DGP-IgA), which are produced in the small intestine and are more specific for diagnosing celiac disease. However, for individuals with IgA deficiency, DGP-IgG testing is also available and provides valuable diagnostic information. To perform the DGP test, a venous blood sample is collected, and the serum is analyzed using immunoassay techniques, such as enzyme-linked immunosorbent assay (ELISA) or multiplexed bead assay. It is important to note that DGP testing is often conducted alongside other antibody tests for celiac disease and is particularly beneficial for diagnosing children under the age of 2 years. For accurate results, it is essential that the individual continues to consume gluten in their diet, as the absence of gliadin will result in no detectable antibody response.
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The gliadin (deamidated) (DGP) antibody test is indicated for the evaluation of celiac disease, particularly in individuals presenting with symptoms suggestive of this condition. The following are specific indications for performing the DGP test:
The procedure for conducting the gliadin (deamidated) (DGP) antibody test involves several key steps, which are outlined below:
After the gliadin (deamidated) (DGP) antibody test is performed, there are no specific post-procedure care requirements for the patient. However, it is important for the patient to follow up with their healthcare provider to discuss the test results and any further diagnostic steps that may be necessary. If the test indicates the presence of antibodies associated with celiac disease, the healthcare provider may recommend additional testing or dietary modifications. Patients should be advised to maintain their gluten-containing diet until all necessary testing is completed, as removing gluten prematurely can lead to inaccurate test results.
| Short Descr | DGP ANTIBODY EACH IG CLASS | Medium Descr | GLIADIN ANTIBODY EACH IMMUNOGLOBULIN CLASS | Long Descr | Gliadin (deamidated) (DGP) antibody, each immunoglobulin (Ig) class | 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) | none | MUE | 3 |
| 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. | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | 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. | AY | Item or service furnished to an esrd patient that is not for the treatment of esrd | GA | Waiver of liability statement issued as required by payer policy, individual case | GW | Service not related to the hospice patient's terminal condition | 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 | GZ | Item or service expected to be denied as not reasonable and necessary |
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| 2022-01-01 | Added | Code added |
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