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The CPT® Code 85245 refers to a laboratory test that measures the levels of factor VIII, von Willebrand (VW) factor, and ristocetin cofactor in the blood. Factor VIII, also known as antihemophilic factor, is a crucial protein in the blood coagulation process, playing a significant role in the formation of blood clots. It works in conjunction with von Willebrand factor, which is essential for stabilizing factor VIII and facilitating its procoagulant activity. Von Willebrand factor exists in two distinct forms: one that circulates freely in the plasma and another that is bound to the alpha granules of circulating platelets. The synthesis and release of plasma von Willebrand factor occur in the vascular endothelial cells, while the platelet-bound form is produced by megakaryocytes in the bone marrow. The test for ristocetin cofactor specifically assesses the activity of von Willebrand factor and its effectiveness in promoting blood clot formation in response to vascular injury. This test is particularly important in the initial evaluation of von Willebrand disease, a bleeding disorder characterized by deficiencies in von Willebrand factor. To perform this test, a blood sample is collected through a venipuncture, which is a separately reportable procedure. The analysis is conducted on platelet-poor plasma using a method known as platelet agglutination, which evaluates the interaction between platelets and von Willebrand factor under the influence of ristocetin.
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The CPT® Code 85245 is indicated for use in various clinical scenarios where assessment of coagulation factors is necessary. The following conditions may warrant the performance of this test:
The procedure for conducting the test associated with CPT® Code 85245 involves several key steps, which are outlined below:
After the completion of the test associated with CPT® Code 85245, the patient may be monitored briefly to ensure there are no immediate complications from the venipuncture. The results of the test will typically be analyzed and reported by the laboratory, and the healthcare provider will discuss the findings with the patient. Depending on the results, further diagnostic testing or treatment options may be considered, especially if von Willebrand disease or another bleeding disorder is suspected. It is important for healthcare providers to interpret the results in conjunction with the patient's clinical history and other laboratory findings to make informed decisions regarding management and treatment.
| Short Descr | CLOT FACTOR VIII VW RISTOCTN | Medium Descr | CLOTTING FACTOR VIII VW FACTOR RISTOCETIN COFACT | Long Descr | Clotting; factor VIII, VW factor, ristocetin cofactor | 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. | 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 | GW | Service not related to the hospice patient's terminal condition | 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 | GZ | Item or service expected to be denied as not reasonable and necessary | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2013-01-01 | Changed | Short Descriptor changed. |
| 1993-01-01 | Added | First appearance in code book in 1993. |
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