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The CPT® Code 85210 refers to a laboratory test specifically designed to measure the activity of factor II, also known as prothrombin. Prothrombin is a crucial protein in the blood coagulation process, produced in the liver and dependent on vitamin K for its synthesis. This proenzyme undergoes proteolytic cleavage to form thrombin, which plays a vital role in the coagulation cascade, facilitating the conversion of fibrinogen to fibrin, thereby aiding in blood clot formation. A deficiency in prothrombin can arise from various causes, including inherited genetic disorders, liver disease, vitamin K deficiency, anticoagulant therapy, or autoimmune disorders. Clinically, individuals with prothrombin deficiency may present with symptoms such as easy bruising, frequent nosebleeds, soft tissue hemorrhages, and excessive bleeding during surgical procedures or menstruation. Conversely, elevated prothrombin levels may indicate a mutation known as prothrombin 20210A, which is associated with an increased risk of thrombus formation due to excessive clotting. The prothrombin activity test is typically ordered when patients exhibit abnormal results in bleeding time tests, such as prothrombin time (PT) or activated partial thromboplastin time (PTT), or when there is a family history of coagulation factor deficiencies. Additionally, this test can be utilized to monitor the severity of any identified factor defects and the effectiveness of ongoing treatment. The test is performed on platelet-poor plasma obtained from a blood sample, which is collected through a separately reportable venipuncture, and analyzed using a prothrombin clot-based assay.
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The prothrombin activity test (CPT® Code 85210) is indicated for several clinical scenarios, particularly when there are concerns regarding coagulation factors and bleeding disorders. The following conditions may warrant the performance of this test:
The procedure for conducting the prothrombin activity test involves several key steps to ensure accurate measurement of factor II activity. The following outlines the procedural steps:
After the prothrombin activity test is completed, the patient may be monitored for any immediate complications related to the venipuncture, such as bleeding or bruising at the site of blood draw. Results from the test will typically be analyzed and reported back to the ordering physician, who will interpret the findings in the context of the patient's clinical history and symptoms. Depending on the results, further diagnostic testing or treatment adjustments may be necessary to address any identified coagulation issues. It is important for healthcare providers to communicate the results effectively to the patient and discuss any required follow-up actions or additional testing that may be indicated.
| Short Descr | CLOT FACTOR II PROTHROM SPEC | Medium Descr | CLOTTING FACTOR II PROTHROMBIN SPECIFIC | Long Descr | Clotting; factor II, prothrombin, specific | 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 | 2 | CCS Clinical Classification | 233 - Laboratory - Chemistry and Hematology |
| 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. | 26 | Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number. | 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. | 91 | Repeat clinical diagnostic laboratory test: in the course of treatment of the patient, it may be necessary to repeat the same laboratory test on the same day to obtain subsequent (multiple) test results. under these circumstances, the laboratory test performed can be identified by its usual procedure number and the addition of modifier 91. note: this modifier may not be used when tests are rerun to confirm initial results; due to testing problems with specimens or equipment; or for any other reason when a normal, one-time, reportable result is all that is required. this modifier may not be used when other code(s) describe a series of test results (eg, glucose tolerance tests, evocative/suppression testing). this modifier may only be used for laboratory test(s) performed more than once on the same day on the same patient. | 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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| 2013-01-01 | Changed | Description Changed |
| Pre-1990 | Added | Code added. |
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