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The CPT® Code 85397 pertains to the evaluation of coagulation and fibrinolysis functional activity, specifically for analytes that are not otherwise specified, such as ADAMTS-13. This procedure involves obtaining a blood sample through a venipuncture, which is a method of drawing blood from a vein. Coagulation refers to the physiological process by which blood changes from a liquid to a gel, forming a blood clot, while fibrinolysis is the process that breaks down fibrin in blood clots, allowing for the restoration of normal blood flow. The balance between these two processes is crucial for maintaining hemostasis, and any disruption can lead to coagulation disorders. ADAMTS-13 is a specific protease that plays a significant role in the regulation of blood clotting. The presence of certain autoantibodies, particularly immunoglobulin G (IgG) against ADAMTS-13, can inhibit its activity, leading to conditions such as thrombotic thrombocytopenic purpura (TTP), a serious blood disorder characterized by the formation of small blood clots throughout the body. The testing for ADAMTS-13 is typically performed using an enzyme-linked immunosorbent assay (ELISA), which quantitatively measures the functional activity of this protease. Additionally, this code can be used for testing other analytes or proteins involved in coagulation and fibrinolysis, utilizing various assay methods as appropriate. It is important to report code 85397 for each analyte that is tested in the evaluation process.
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The procedure associated with CPT® Code 85397 is indicated for the evaluation of coagulation and fibrinolysis functional activity in patients who may be experiencing coagulation disorders. Specific indications for this testing include:
The procedure for CPT® Code 85397 involves several key steps to ensure accurate testing of coagulation and fibrinolysis functional activity:
After the procedure associated with CPT® Code 85397, patients may be advised on post-venipuncture care, which typically includes applying pressure to the puncture site to minimize bleeding and preventing the use of the affected arm for strenuous activities for a short period. The results of the coagulation and fibrinolysis tests will be communicated to the healthcare provider, who will discuss the implications of the findings with the patient. Depending on the results, further diagnostic testing or treatment may be necessary to address any identified coagulation disorders.
| Short Descr | CLOTTING FUNCT ACTIVITY | Medium Descr | COAGJ&FIBRINOLYSIS FUNCTIONAL ACTV NOS EA ANAL | Long Descr | Coagulation and fibrinolysis, functional activity, not otherwise specified (eg, ADAMTS-13), each analyte | 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. | 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. | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study |
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| 2013-01-01 | Changed | Medium Descriptor changed. |
| 2009-01-01 | Added | - |
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