CPT® Code 88740

Official Description

Hemoglobin, quantitative, transcutaneous, per day; carboxyhemoglobin

Common Language Description

The CPT® Code 88740 refers to a quantitative transcutaneous hemoglobin test specifically for measuring carboxyhemoglobin levels. Carboxyhemoglobin is formed when carbon monoxide binds with hemoglobin in the blood, which can occur due to inhalation of carbon monoxide, a colorless and odorless gas that can be produced by burning fossil fuels. This binding impairs the blood's ability to transport oxygen and carbon dioxide, leading to potential health risks, including carbon monoxide poisoning, which can be life-threatening. The test is crucial for diagnosing and monitoring patients who may have been exposed to carbon monoxide, as elevated levels of carboxyhemoglobin indicate a significant risk of asphyxiation. Additionally, the test can also measure methemoglobin levels, which is another form of hemoglobin that is unable to carry oxygen effectively. Under normal circumstances, methemoglobin constitutes only a small percentage (1-2%) of total hemoglobin. However, certain genetic disorders or exposure to specific toxins can lead to increased levels, resulting in a condition known as methemoglobinemia, which can cause various health complications. The procedure utilizes a noninvasive method involving an eight-wavelength pulse oximeter, which is a device that measures the levels of carboxyhemoglobin or methemoglobin through the skin. The sensor is typically placed on the patient's finger, allowing for continuous monitoring of hemoglobin levels on a daily basis, thereby providing essential information for clinical decision-making and patient management.

1. Indications

The quantitative transcutaneous hemoglobin test for carboxyhemoglobin (CPT® Code 88740) is indicated for the following conditions:

Carbon Monoxide Exposure: This test is performed to assess levels of carboxyhemoglobin in patients suspected of carbon monoxide poisoning due to inhalation of carbon monoxide.
Monitoring Carbon Monoxide Poisoning: It is used to monitor patients who have been diagnosed with carbon monoxide poisoning to evaluate the effectiveness of treatment and recovery.
Assessment of Asphyxiation Risk: The test may be indicated in situations where there is a risk of asphyxiation due to elevated carbon monoxide levels in the environment.
Methemoglobinemia Evaluation: The procedure can also be utilized to measure methemoglobin levels in patients who may have genetic conditions or have been exposed to certain toxins that could elevate these levels.

2. Procedure

The procedure for conducting the quantitative transcutaneous hemoglobin test for carboxyhemoglobin involves several key steps:

Preparation of the Patient: The patient is positioned comfortably, and the area on the finger where the sensor will be placed is cleaned to ensure accurate readings. It is important to ensure that the patient is calm and relaxed to avoid any physiological changes that could affect the results.
Placement of the Sensor: An eight-wavelength pulse oximeter sensor is attached to the patient's finger. This device is designed to measure the levels of carboxyhemoglobin or methemoglobin transcutaneously, meaning it assesses the levels through the skin without the need for invasive blood draws.
Measurement Process: The pulse oximeter emits light at different wavelengths, which passes through the skin and is absorbed by the blood. The device calculates the levels of carboxyhemoglobin or methemoglobin based on the absorption characteristics of the light, providing a quantitative measurement.
Data Interpretation: The results are displayed on the device, indicating the concentration of carboxyhemoglobin or methemoglobin in the blood. These results are typically monitored on a per day basis to track any changes in the patient's condition.

3. Post-Procedure

After the procedure, the patient may be monitored for any immediate reactions to the test. Since the test is noninvasive, there are generally no significant post-procedure care requirements. However, healthcare providers may review the results with the patient and discuss any necessary follow-up actions based on the levels of carboxyhemoglobin or methemoglobin detected. If elevated levels are found, further medical evaluation and treatment may be warranted to address potential carbon monoxide poisoning or methemoglobinemia. Continuous monitoring may be recommended for patients at risk or those undergoing treatment for elevated levels.

Short Descr	TRANSCUTANEOUS CARBOXYHB
Medium Descr	HEMOGLOBIN QUAN TC PER DAY CARBOXYHEMOGLOBIN
Long Descr	Hemoglobin, quantitative, transcutaneous, per day; carboxyhemoglobin
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

Multiple outpatient hospital e/m encounters on the same date: for hospital outpatient reporting purposes, utilization of hospital resources related to separate and distinct e/m encounters performed in multiple outpatient hospital settings on the same date may be reported by adding modifier 27 to each appropriate level outpatient and/or emergency department e/m code(s). this modifier provides a means of reporting circumstances involving evaluation and management services provided by physician(s) in more than one (multiple) outpatient hospital setting(s) (eg, hospital emergency department, clinic). note: this modifier is not to be used for physician reporting of multiple e/m services performed by the same physician on the same date. for physician reporting of all outpatient evaluation and management services provided by the same physician on the same date and performed in multiple outpatient setting(s) (eg, hospital emergency department, clinic), see evaluation and management, emergency department, or preventive medicine services codes.