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The chromogenic substrate assay, identified by CPT® Code 85130, is a specialized analytical technique utilized to assess enzyme activity within biological samples. This method involves the addition of a chromogenic-linked substrate to a sample of body tissue or fluid, resulting in a color change that correlates with the activity level of the specific enzyme or factor being measured. The intensity of the color produced serves as an indicator of the relative activity of the target factor, allowing for quantitative analysis. This assay is particularly valuable in the context of evaluating the effects of anti-thrombotic medications, such as heparin, as well as in the assessment of anticoagulant proteins like antithrombin (AT) and Protein C (PC). Additionally, it plays a role in the analysis of various components of the fibrinolytic system. To perform this assay, a blood sample is required, which is obtained through a separately reportable venipuncture procedure. Furthermore, the assay can be employed to quantitatively test plasma for heparin cofactor II, enhancing its utility in clinical settings where monitoring of coagulation factors is essential.
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The chromogenic substrate assay is indicated for various clinical scenarios where enzyme activity needs to be evaluated. The following conditions and situations warrant the use of this assay:
The procedure for conducting a chromogenic substrate assay involves several key steps that ensure accurate measurement of enzyme activity. The following outlines the procedural steps:
After the chromogenic substrate assay is completed, the results are analyzed and interpreted by qualified healthcare professionals. It is important to ensure that the findings are documented accurately in the patient's medical record. Depending on the results, further clinical actions may be required, such as adjustments to anticoagulant therapy or additional testing. Patients may not require specific post-procedure care related to the assay itself, but standard post-venipuncture care should be provided to prevent complications such as hematoma or bleeding at the puncture site. Continuous monitoring of the patient's coagulation status may be necessary based on the assay results and the clinical context.
| Short Descr | CHROMOGENIC SUBSTRATE ASSAY | Medium Descr | CHROMOGENIC SUBSTRATE ASSAY | Long Descr | Chromogenic substrate assay | 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 |
| 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. | 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. | GA | Waiver of liability statement issued as required by payer policy, individual case | 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 |
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| 1993-01-01 | Added | First appearance in code book in 1993. |
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