CPT® Code 85291

1. Indications

The CPT® Code 85291 is indicated for use in various clinical scenarios where there is a suspicion of factor XIII deficiency. The following conditions may warrant the performance of this test:

• Early Spontaneous Miscarriage A history of recurrent early miscarriages in women may suggest a potential deficiency in clotting factors, including factor XIII.
• Heavy Menstrual Bleeding Women experiencing excessive menstrual bleeding may be evaluated for clotting disorders, including factor XIII deficiency.
• Umbilical Stump Bleeding in Infants Infants who exhibit bleeding from the umbilical stump may require testing for clotting factor deficiencies, including factor XIII.
• Central Nervous System Bleeding In children, central nervous system bleeding following mild head trauma or spontaneous bleeding in adults may indicate a need for factor XIII screening.
• Bruising and Soft Tissue Bleeding Patients presenting with unexplained bruising or soft tissue bleeding, particularly in the gums, muscles, and joints, may be evaluated for factor XIII deficiency.

2. Procedure

The procedure for performing the test associated with CPT® Code 85291 involves several key steps, which are outlined below:

• Step 1: Patient Preparation Prior to the test, the patient may be instructed to avoid certain medications or supplements that could affect clotting factors. It is essential to ensure that the patient is adequately informed about the procedure.
• 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 sample is crucial for the subsequent analysis.
• Step 3: Plasma Preparation Once the blood sample is collected, it is processed to obtain platelet-poor plasma. This involves centrifuging the blood to separate the plasma from the cellular components, ensuring that the analysis focuses solely on the plasma.
• Step 4: Qualitative Solubility Testing The prepared platelet-poor plasma is then subjected to qualitative solubility testing to assess the presence and functionality of factor XIII. This step determines whether the factor is soluble and functioning correctly.
• Step 5: Interpretation of Results After the testing is completed, the results are interpreted. If the qualitative test indicates a deficiency, further testing with the quantitative test (CPT® Code 85290) may be recommended for a more comprehensive evaluation.

3. Post-Procedure

After the completion of the factor XIII solubility test, there are several considerations for post-procedure care. Patients may be advised to resume normal activities immediately, as venipuncture typically does not require extensive recovery time. However, they should be monitored for any signs of excessive bleeding or bruising at the puncture site. If the initial test results are positive for factor XIII deficiency, healthcare providers may discuss the need for further testing, such as the quantitative assessment, to confirm the diagnosis and determine appropriate management strategies. It is also essential for healthcare professionals to provide patients with information regarding potential symptoms of factor XIII deficiency and when to seek medical attention.