CPT® Code 85280

Official Description

Clotting; factor XII (Hageman)

Common Language Description

The CPT® Code 85280 refers to a laboratory test specifically designed to measure the activity of factor XII, also known as Hageman factor. This factor plays a crucial role in the coagulation cascade, which is the series of events that lead to blood clot formation. Factor XII is a plasma transglutaminase that catalyzes the final step in this cascade, enabling the formation of fibrin, a protein that solidifies the clot and provides a structural framework for healing. Additionally, factor XII is involved in binding fibronectin, 2-plasmin inhibitor, and collagen to the fibrin plug at the site of a wound, which is essential for effective hemostasis. A deficiency in factor XII is a rare genetic disorder that can lead to significant bleeding complications, affecting both males and females equally. This deficiency may also present as an acquired condition due to various factors such as hepatic failure, inflammatory bowel disease, or myeloid leukemia. Notably, approximately 80% of infants born with congenital factor XII deficiency experience bleeding from the umbilical stump. Furthermore, central nervous system bleeding can occur in infants after a normal delivery or in individuals of any age following minor head trauma. Women with this deficiency are at an increased risk for spontaneous abortions. Other clinical manifestations may include bleeding in soft tissues or joints and delayed wound healing. The test for factor XII activity is particularly useful for diagnosing factor XII deficiency or for investigating the underlying causes of prolonged activated thromboplastin time (aPTT). To perform this test, a blood sample is collected through a venipuncture, and the analysis is conducted on platelet-poor plasma using an activated partial thromboplastin clot-based assay.

1. Indications

The CPT® Code 85280 is indicated for use in specific clinical scenarios where the measurement of factor XII (Hageman factor) activity is necessary. The following conditions and symptoms may warrant this laboratory test:

Factor XII Deficiency This test is utilized to diagnose a deficiency of factor XII, which is a rare inherited genetic disorder that can lead to severe bleeding complications.
Prolonged Activated Thromboplastin Time (aPTT) The test may be performed to determine the cause of an extended aPTT, which can indicate potential coagulation disorders.
Bleeding Disorders It is indicated in patients presenting with unexplained bleeding episodes, including soft tissue or joint bleeding.
Umbilical Stump Bleeding in Infants The test is particularly relevant for infants who exhibit umbilical stump bleeding, as 80% of those with congenital factor XII deficiency experience this symptom.
Spontaneous Abortion in Women Women with a history of spontaneous abortions may be tested for factor XII deficiency, as there is a noted high incidence of this condition in such cases.

2. Procedure

The procedure for testing factor XII activity involves several key steps that ensure accurate measurement and analysis. The following outlines the procedural steps:

Step 1: Patient Preparation Prior to the test, the patient may be instructed to avoid certain medications or foods that could affect coagulation. It is essential to gather a thorough medical history to identify any potential bleeding disorders or relevant conditions.
Step 2: Venipuncture A blood sample is obtained through a venipuncture, which is a standard procedure where a needle is inserted into a vein, typically in the arm, to collect blood. This step is crucial as the sample must be collected in a manner that minimizes contamination and ensures the integrity of the plasma for testing.
Step 3: Plasma Preparation After collection, the blood sample is processed to obtain platelet-poor plasma. This is achieved by centrifuging the blood to separate the plasma from the cellular components, which is necessary for accurate testing of factor XII activity.
Step 4: Testing The prepared platelet-poor plasma is then subjected to an activated partial thromboplastin clot-based assay. This assay measures the time it takes for a clot to form in the presence of specific activators, allowing for the assessment of factor XII activity.
Step 5: Result Interpretation Once the assay is complete, the results are analyzed and interpreted by a qualified laboratory professional. The findings will indicate whether factor XII activity is within normal ranges or if a deficiency is present, guiding further clinical management.

3. Post-Procedure

After the procedure, patients may be advised to monitor for any signs of bleeding or bruising at the venipuncture site. Typically, there are no significant post-procedure complications associated with this test. However, if the patient experiences unusual symptoms or prolonged bleeding, they should seek medical attention. The results of the factor XII activity test will be communicated to the healthcare provider, who will discuss the implications of the findings and any necessary follow-up actions or treatments based on the results.

Short Descr	CLOT FACTOR XII HAGEMAN
Medium Descr	CLOTTING FACTOR XII HAGEMAN
Long Descr	Clotting; factor XII (Hageman)
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.
Q4	Service for ordering/referring physician qualifies as a service exemption