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The CPT® Code 85379 refers to the quantitative measurement of fibrin degradation products, specifically D-dimer. This test is crucial in the clinical setting as it aids in ruling out the presence of a thrombus, which is a blood clot that can obstruct blood flow. D-dimer testing is particularly significant in evaluating conditions associated with hypercoagulability, where there is an increased tendency for blood to clot. The test's negative predictive value is a key feature; a negative result suggests that there are no elevated levels of fibrin degradation products in the specimen, indicating a lower likelihood of thrombotic events. Conversely, a positive result signifies an abnormally high concentration of these degradation products, which may suggest the presence of a thrombus. D-dimer testing is instrumental in diagnosing various medical conditions, including deep vein thrombophlebitis, pulmonary embolism, and stroke. Additionally, it plays a role in assessing hypercoagulability, which can predispose patients to the formation of blood clots. The test is also utilized in the diagnosis and management of disseminated intravascular coagulation (DIC), a serious condition characterized by the widespread activation of the clotting process. The quantitative nature of the test, as indicated by CPT® Code 85379, provides precise levels of fibrin degradation products, allowing for more accurate clinical decision-making. In contrast, related codes such as 85378 and 85380 pertain to qualitative and semiquantitative testing methodologies, which differ in sensitivity and specificity. Overall, the D-dimer test is a vital tool in the diagnostic arsenal for conditions related to thrombosis and coagulation disorders.
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The D-dimer test, represented by CPT® Code 85379, is indicated for several clinical scenarios where the presence of thrombus or hypercoagulability is suspected. The following conditions warrant the use of this test:
The procedure for conducting the D-dimer test under CPT® Code 85379 involves several key steps to ensure accurate quantitative measurement of fibrin degradation products:
After the D-dimer test is performed, there are generally no specific post-procedure care requirements for the patient, as the test is minimally invasive. Patients may resume normal activities immediately following the blood draw. However, it is essential for healthcare providers to monitor the patient’s clinical status and consider the implications of the test results. If the D-dimer levels are elevated, further diagnostic imaging or clinical evaluation may be warranted to confirm the presence of thrombotic conditions or to assess the need for treatment interventions. Additionally, the healthcare provider may discuss the results with the patient and outline any necessary follow-up actions based on the findings.
| Short Descr | FIBRIN DEGRADATION QUANT | Medium Descr | FIBRIN DGRADJ PRODUCTS D-DIMER QUANTITATIVE | Long Descr | Fibrin degradation products, D-dimer; quantitative | 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. | Q4 | Service for ordering/referring physician qualifies as a service exemption | 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. | 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. | GW | Service not related to the hospice patient's terminal condition | GA | Waiver of liability statement issued as required by payer policy, individual case | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | 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 | 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. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | GC | This service has been performed in part by a resident under the direction of a teaching physician | GZ | Item or service expected to be denied as not reasonable and necessary | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | QW | Clia waived test | SA | Nurse practitioner rendering service in collaboration with a physician | UH | Services provided in the evening | X5 | Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | 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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| 2011-01-01 | Changed | Short description changed. |
| 1993-01-01 | Added | First appearance in code book in 1993. |
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