© Copyright 2025 American Medical Association. All rights reserved.
The CPT® Code 80439 refers to the Thyrotropin releasing hormone (TRH) stimulation panel, specifically designed for a 2-hour testing period. This panel is utilized to assess the functionality of the hypothalamus and pituitary gland in regulating thyroid hormones, particularly in cases of suspected pituitary (secondary) and tertiary (hypothalamic) hypothyroidism. The hypothalamus plays a crucial role in this regulatory process by releasing thyrotropin releasing hormone (TRH) when it detects low levels of the thyroid hormones T4 (thyroxine) and T3 (triiodothyronine) in the bloodstream. The release of TRH prompts the pituitary gland to secrete thyroid stimulating hormone (TSH), which subsequently stimulates the thyroid gland to produce and release T4 and T3. It is important to note that the TRH stimulation testing has become less common due to the introduction of the third-generation TSH test, which offers improved accuracy and reliability. Additionally, the availability of the necessary drug, Protirelin, for the TRH test has diminished. The procedure involves the insertion of an intravenous (IV) line, which is a separately reportable procedure. A baseline blood sample is collected from this IV line or through a separate venipuncture to measure initial TSH levels. Following this, Protirelin (TRH) is administered via IV push at a dosage of 200 mcg. For the 2-hour stimulation panel, blood samples are taken at three intervals: 20 minutes, 60 minutes, and 120 minutes post-administration to evaluate the TSH response. The serum or plasma samples obtained are then analyzed using a quantitative chemiluminescent immunoassay to determine the levels of TSH in the bloodstream.
© Copyright 2025 Coding Ahead. All rights reserved.
The Thyrotropin releasing hormone (TRH) stimulation panel, CPT® Code 80439, is indicated for the evaluation of patients suspected of having pituitary (secondary) or tertiary (hypothalamic) hypothyroidism. This testing is particularly relevant in cases where there is a need to assess the functionality of the hypothalamic-pituitary-thyroid axis, especially when clinical symptoms suggest an underlying thyroid dysfunction.
The procedure for the TRH stimulation panel involves several critical steps to ensure accurate measurement of TSH levels in response to TRH administration. First, an intravenous (IV) line is established, which is necessary for the administration of Protirelin (TRH) and for drawing blood samples. This step is performed as a separately reportable procedure. Following the establishment of the IV line, a baseline blood sample is collected either from the IV line or through a separate venipuncture to measure initial TSH levels. This baseline measurement is crucial for comparison with subsequent TSH levels after TRH administration.
After the completion of the TRH stimulation panel, patients may be monitored for any immediate reactions to the TRH administration. The expected recovery is generally quick, as the procedure is minimally invasive. However, it is essential to ensure that patients are informed about any potential side effects associated with the administration of Protirelin. The collected serum or plasma samples will be sent for analysis using a quantitative chemiluminescent immunoassay, and results will typically be available within a specified timeframe, allowing for timely clinical decision-making based on the TSH levels obtained.
| Short Descr | TRH STIMULATION PANEL | Medium Descr | THYROTROPIN RELEASING HORMONE STMLJ PANEL 2 HR | Long Descr | Thyrotropin releasing hormone (TRH) stimulation panel; 2 hour This panel must include the following: Thyroid stimulating hormone (TSH) (84443 x 4) | 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 |
| 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. |
|
Date
|
Action
|
Notes
|
|---|---|---|
| 2009-01-01 | Changed | Code description changed |
| 1994-01-01 | Added | First appearance in code book in 1994. |