CPT® Code 85290

Official Description

Clotting; factor XIII (fibrin stabilizing)

Common Language Description

The CPT® Code 85290 refers to a laboratory test that measures the activity of clotting factor XIII, which is also known as fibrin stabilizing factor. This factor plays a crucial role in the preservation of blood clots, wound repair, and the overall healing process. A deficiency in factor XIII can lead to significant clinical issues, including defects in fibrin cross-linking, which may result in early spontaneous miscarriages or heavy menstrual bleeding in women. In infants, a deficiency can cause bleeding from the umbilical stump, while in children, it may lead to central nervous system bleeding following mild head trauma or spontaneously in adults. Additionally, individuals with factor XIII deficiency may experience bruising and soft tissue bleeding, particularly in the gums, muscles, and joints. Factor XIII deficiency is typically attributed to a rare inherited genetic disorder; however, it can also arise when auto-antibodies are triggered by certain medications, such as isoniazid. The test for factor XIII is most commonly ordered to confirm a deficiency when a qualitative test has yielded positive results. It is also utilized to monitor treatment in patients who are already known to have this deficiency. Furthermore, the test can be beneficial in evaluating patients who exhibit symptoms of abnormal bleeding, especially when standard bleeding time tests, such as prothrombin time (PT), activated partial thromboplastin time (PTT), and platelet levels, return normal results. To perform this test, a blood sample is collected through a separately reportable venipuncture, and the analysis is conducted on platelet-poor plasma using a chromogenic assay.

1. Indications

The CPT® Code 85290 is indicated for use in various clinical scenarios where the assessment of clotting factor XIII activity is necessary. The following conditions and symptoms may warrant the performance of this test:

Deficiency Confirmation The test is primarily ordered to confirm a suspected deficiency of factor XIII when a qualitative test has returned positive results.
Monitoring Treatment It is utilized to monitor the treatment and management of patients who are already diagnosed with factor XIII deficiency.
Abnormal Bleeding Evaluation The test can be beneficial in evaluating patients who present with symptoms of abnormal bleeding, particularly when standard bleeding time tests (PT, PTT) and platelet levels are within normal ranges.

2. Procedure

The procedure for conducting the test associated with CPT® Code 85290 involves several key steps that ensure accurate measurement of factor XIII activity. The following outlines the procedural steps:

Step 1: Blood Sample Collection A blood sample is obtained from the patient through a venipuncture. This step is crucial as it provides the necessary specimen for testing. The blood must be collected in a manner that minimizes contamination and ensures the integrity of the sample.
Step 2: Preparation of Platelet-Poor Plasma After collection, the blood sample is processed to separate the plasma from the cellular components. This is typically achieved through centrifugation, which allows for the isolation of platelet-poor plasma, essential for the subsequent testing.
Step 3: Testing Using Chromogenic Assay The platelet-poor plasma is then subjected to a chromogenic assay. This assay is designed to quantitatively measure the activity of factor XIII, providing a clear indication of the clotting factor's functionality.

3. Post-Procedure

After the completion of the factor XIII activity test, there are no specific post-procedure care requirements mentioned. However, it is essential for healthcare providers to monitor the patient for any potential adverse reactions related to the venipuncture, such as bruising or discomfort at the site of blood collection. The results of the test will be analyzed and interpreted by the healthcare provider, who will then discuss the findings with the patient and determine any necessary follow-up actions or treatments based on the results.

Short Descr	CLOT FACTOR XIII FIBRIN STAB
Medium Descr	CLOTTING FACTOR XIII FIBRIN STABILIZING
Long Descr	Clotting; factor XIII (fibrin stabilizing)
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.
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
GA	Waiver of liability statement issued as required by payer policy, individual case