CPT® Code 88720

1. Indications

The total transcutaneous bilirubin (TcB) test is indicated for the assessment of bilirubin levels in patients, particularly in newborns, to monitor for conditions such as:

• Hyperbilirubinemia A condition characterized by elevated levels of bilirubin in the blood, which can lead to jaundice.
• Jaundice A clinical sign that presents as yellowing of the skin and eyes, often due to high bilirubin levels.
• Assessment of liver function To evaluate the liver's ability to process bilirubin, especially in cases of suspected liver disease.

2. Procedure

The procedure for performing a total transcutaneous bilirubin (TcB) test involves several key steps to ensure accurate measurement of bilirubin levels:

• Step 1: Device Initialization The bilirubin analyzer device is turned on and initialized. This step is crucial as it prepares the device for operation and ensures that it is functioning correctly.
• Step 2: Self-Test The device performs a self-test to verify that all components are working properly. This self-check is essential for ensuring the reliability of the measurements that will follow.
• Step 3: Calibration The device is calibrated to ensure accurate readings. Calibration involves adjusting the device to account for any variations in skin characteristics that may affect the results.
• Step 4: Application of the Device The tester presses the tip of the handheld device against the patient's forehead or sternum. This location is chosen for its accessibility and the minimal interference from other skin components.
• Step 5: Light Reflection Measurement The device emits light that penetrates the skin and is reflected back. The analyzer evaluates the reflected light to determine the bilirubin concentration by assessing the spectral reflectance affected by skin components such as collagen, melanin, hemoglobin, and bilirubin.
• Step 6: Measurement Completion After the initial measurement, the device is lifted away from the skin. This marks the completion of the first measurement, and a series of five measurements are typically performed to ensure accuracy and reliability.
• Step 7: Calculation and Display Following the fifth measurement, the device calculates the total bilirubin level and displays the result. This final output provides the healthcare provider with the necessary information to assess the patient's bilirubin levels.

3. Post-Procedure

After the total transcutaneous bilirubin (TcB) test is completed, there are no specific post-procedure care requirements due to the noninvasive nature of the test. Patients can resume their normal activities immediately. However, healthcare providers should interpret the results in conjunction with clinical findings and may recommend further testing or monitoring if elevated bilirubin levels are detected. It is important to document the results accurately in the patient's medical record for ongoing assessment and management of any underlying conditions.