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The Nitroblue tetrazolium dye test (NTD), identified by CPT® Code 86384, is a diagnostic procedure utilized primarily for the screening of chronic granulomatous disease (CGD). CGD is a complex and heterogeneous genetic disorder characterized by the inability of phagocytes, a type of immune cell, to effectively kill certain ingested microorganisms. This deficiency results in the individual experiencing severe and recurrent pyogenic infections, which are infections caused by pus-forming bacteria. The NTD test functions by assessing the capability of specific immune system cells, particularly neutrophils, to convert a colorless chemical, nitroblue tetrazolium, into a deep blue pigment. In healthy individuals, the white blood cells will successfully undergo this color change upon exposure to the dye, indicating normal phagocytic function. Conversely, in individuals with CGD, the white blood cells will not exhibit this color change, thereby failing to turn blue, which serves as a critical indicator of the disease. This test is essential for early diagnosis and management of CGD, allowing for timely intervention and treatment to prevent serious infections.
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The Nitroblue tetrazolium dye test (NTD) is indicated for the following conditions:
The Nitroblue tetrazolium dye test involves several key procedural steps to accurately assess the functionality of the immune system's phagocytes. The procedure begins with the collection of a blood sample from the patient, typically drawn from a vein in the arm. This sample is then placed in a test tube containing the nitroblue tetrazolium dye. Following this, the blood sample is incubated under controlled conditions to allow the immune cells to interact with the dye. After the incubation period, the sample is examined microscopically. The presence of blue-stained cells indicates normal phagocytic activity, as the neutrophils have successfully converted the nitroblue tetrazolium into a blue formazan product. In contrast, if the neutrophils remain colorless, this suggests a failure in the oxidative burst mechanism, which is characteristic of chronic granulomatous disease. The results of this test are crucial for diagnosing CGD and guiding further clinical management.
After the Nitroblue tetrazolium dye test is completed, there are generally no specific post-procedure care requirements, as the test is minimally invasive and involves only a standard blood draw. Patients may experience slight discomfort or bruising at the site of the blood draw, which typically resolves quickly. It is important for healthcare providers to communicate the results of the test to the patient, as a positive indication of CGD may necessitate further diagnostic testing or referral to a specialist for comprehensive management of the condition. Additionally, patients should be advised to report any unusual symptoms or concerns following the procedure.
| Short Descr | NITROBLUE TETRAZOLIUM DYE | Medium Descr | NITROBLUE TETRAZOLIUM DYE TEST NTD | Long Descr | Nitroblue tetrazolium dye test (NTD) | 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 | 235 - Other Laboratory |
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